An institutional theory of welfare state effects on the distribution of population health

Beckfield, Jason; Bambra, Clare; Eikemo, Terje Andreas; Huijts, Tim; McNamara, Courtney L.; Wendt, Claus

doi:10.1057/sth.2015.19

Cited by 211 publications

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“…While this makes the interpretation of our results difficult, we believe our findings offer a starting point for future investigations into institutional mechanisms. [15] Fourth, some of the regions are smaller and more homogenous than the others. Sample sizes were particularly small for the Southern region and results for this region in particular should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

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Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health

McNamara

Toch-Marquardt

Balaj

et al. 2017

European Journal of Public Health

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BackgroundSocioeconomic inequalities in the prevalence of non--communicable diseases (NCDs) are evident across European populations. Several previous studies have addressed the question of whether occupational inequalities in health differ across European regions. It is uncertain however, the degree to which occupational inequalities in NCDs are similar or dissimilar across different European regions. MethodsUsing 2014/15 European Social Survey data from 20 countries, this paper examines occupational inequalities in poor self--rated health (SRH) and 14 self--reported NCDs separately for women and men, by European region: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. Age--controlled adjusted risk ratios were calculated and separately compared a working class and intermediate occupational group with a salariat group. ResultsWorking class Europeans appear to have the highest risk of reporting poor SRH and a number of NCDs. We find inequalities in some NCDS to be the largest in the Northern region, suggesting further evidence of a Nordic paradox. Like some previous work, we did not find larger inequalities in poor SRH in the Central/East region. However, we did find the largest inequalities in this region for some NCDs. Our results do not align completely with previous work which finds smaller health inequalities in Southern Europe. ConclusionsThis work provides a first look at occupational inequalities across a range of NCDs for European men and women by region. Future work is needed to identify the underlying determinants behind regional differences.

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Section: Discussionmentioning

confidence: 99%

“…[15] This theory posits that social policies combine and interact in ways which will impact differently on different health outcomes. Because social policies often vary systematically between groups of countries with similar sociopolitical histories, it is predicted these associations will differ by region.…”

Section: Introductionmentioning

confidence: 99%

Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health

McNamara

Toch-Marquardt

Balaj

et al. 2017

European Journal of Public Health

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“…Immunization, infant mortality, and access to healthcare all exhibit jarring levels of inequality between countries, even those with comparable geographies and similar disease burdens (World Bank 2015). What, then, explains these massive disparities in health coverage and health outcomes brought into stark visibility by the Ebola epidemic (Robinson, Acemoglu, and Johnson 2003)?In this paper we argue that institutional differences -the formal and informal constraints on human interaction (North 1994) -inherited from the colonial period partly explain the large and persistent differences in health systems and the improvements in health they deliver today.Institutions are the rules and regulations of society (Beckfield et al 2015;Kalleberg 2009) and these rules can be, to differing degrees, extractive or inclusive. The former exist when rules do not protect people from exploitation.…”

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confidence: 99%

“…Institutions are the rules and regulations of society (Beckfield et al 2015;Kalleberg 2009) and these rules can be, to differing degrees, extractive or inclusive. The former exist when rules do not protect people from exploitation.…”

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The enduring influence of institutions on universal health coverage: An empirical investigation of 62 former colonies

2018

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Abstract:In this paper, we argue that particular institutional arrangements partly explain the large and persistent differences in health systems and health outcomes observed former colonies countries. Drawing on data from the World Health Organization for 62 countries, covering the period 2000-2014, we explore whether economic (risk of expropriation) and health (complete cause of death registries) institutions explain mortality rates and access to healthcare. To identify this relationship, we use settler mortality and the distance of the capital from the nearest major port -factors associated with institutional arrangements -to explain cross-national variation in health outcomes and the universality of health systems. We find that inclusive institutions arrangements -that protect and acknowledge the rights of citizens -are associated with better health outcomes (e.g. lower infant mortality and lower maternal mortality) as well as with better health systems (e.g. more skilled birth attendance and greater immunization). Inclusive institutions not only foster economic growth but improves health and well-being too (JEL: I10, P16, P51). IOn 20 July 2014, after ravaging the West African countries of Liberia, Sierra Leone, and Guinea, the Ebola virus reached Lagos, Nigeria, one of Africa's largest and most densely populated cities (Tilley-Gyado 2015; WHO 2014). Panic regarding the epidemic intensified instantly. If the virus was not immediately contained, it risked escalating into an irreversible global crisis.* Replication materials are available here: https://github.com/asreeves/origins-health † Icahn School of Medicine at Mount Sinai, michael.miller1@icahn.mssm.edu ‡ Dondena Centre, Bocconi University, veronica.toffolutti@unibocconi.it § London School of Economics and University of Oxford, aaron.reeves@spi.ox.ac.uk 1 Public health officials worried Ebola would expose persistent governance challenges and coordination problems in the Nigerian health system; but these fears did not materialize. The Nigerian government successfully prevented the mass transmission of Ebola, documenting only 19 infections and 7 fatalities (WHO 2016). By contrast, the virus reached epidemic proportions in Liberia, Sierra Leone, and Guinea; with more than 28,600 cases and 11,300 deaths (WHO 2014). The Ebola epidemic illuminates the profound disparities in health systems across West Africa, but these disparities are not only apparent in those few countries directly affected by this localized epidemic. Immunization, infant mortality, and access to healthcare all exhibit jarring levels of inequality between countries, even those with comparable geographies and similar disease burdens (World Bank 2015). What, then, explains these massive disparities in health coverage and health outcomes brought into stark visibility by the Ebola epidemic (Robinson, Acemoglu, and Johnson 2003)?In this paper we argue that institutional differences -the formal and informal constraints on human interaction (North 1994) -inherited from the colonial period partly ...

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“…The academic literature has recently established a strong link between the nature of welfare policy, with the institutional arrangements that it represents, and (inequitable) health outcomes. 2 Different types of welfare policies promoted by successive governments have a lasting impact on population health, and especially its equity dimension. Under the Harper government's austerity agenda, cutbacks to various policy areas associated with SDHs have led to warnings by some about the implications of such cutbacks for health equity.…”

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confidence: 99%

The first federal budget under Prime Minister Justin Trudeau: Addressing social determinants of health?

Rückert¹,

Labonté

2016

Can J Public Health

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A challenging budget environment during the Harper years has meant that crucial investments in the social determinants of health (SDHs) have increasingly been neglected. The tabling of what is widely considered a more progressive budget with expansionary fiscal elements under the new Prime Minister, Justin Trudeau, raises the question as to what extent this budget invests in policy areas that are crucial for achieving a more equitable distribution in the social determinants of health, as promised in the Liberal party platform. In this commentary, we argue that the first Liberal budget represents a step in the right direction, but that this first step needs to be followed up with a sustained commitment to address the pervasive (and unfair) social inequalities that are the root cause of persistent health inequities in Canada. We conclude that the first Trudeau budget, while moving in the right direction, does not fully embody the sustained policy changes needed to effectively address SDHs, including a more expansive role for the federal government in the redistribution of income and wealth.KEY WORDS: Public health; budgets; social determinants of health La traduction du résumé se trouve à la fin de l'article.

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An institutional theory of welfare state effects on the distribution of population health

Cited by 211 publications

References 46 publications

Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health

Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health

The enduring influence of institutions on universal health coverage: An empirical investigation of 62 former colonies

The first federal budget under Prime Minister Justin Trudeau: Addressing social determinants of health?

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