Is democracy good for people's health? A South African perspective

Ncayiyana, Dan

doi:10.1136/bmj.329.7480.1425

Cited by 8 publications

(7 citation statements)

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“…How health care spending affected health outcomes was beyond this paper’s scope, but the findings of greater expenditures as characteristic of democratic nations portends better health outcomes for those populations. Complementary studies of authority structures and health outcomes have been reported [ 44 – 47 ], but additional research is needed.…”

Section: Discussionmentioning

confidence: 99%

Polity and health care expenditures: The association among 159 nations

Gregorio¹,

Gregorio²

2013

JEGH

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This paper hypothesized that democratic nations, as characterized by Polity IV Project regime scores, spend more on health care than autocratic nations and that the association reported here is independent of other demographic, health system or economic characteristics of nations. WHO Global Observatory data on 159 nations with roughly 98% of the world's population were examined. Regime scores had significant, direct and independent associations with each of four measures of health care expenditure. For every unit increment in a nation's regime score toward a more democratic authority structure of governance, we estimated significant (p<0.05) increments in the percent of GDP expended on health care (+0.14%), percent of general government expenditures targeted to health care (+0.25%), total per capita expenditures on health (+34.4Int$) and per capita general government expenditures (+22.4Int$), while controlling for a population's age distribution, life expectancy, health care workforce and system effectiveness and gross national income. Moreover, these relationships were found to persist across socio-economic development levels. The finding that practices of health care expenditure and authority structures of government co-vary is instructive about the politics of health and the challenges of advancing global health objectives.

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Section: Discussionmentioning

confidence: 99%

Polity and health care expenditures: The association among 159 nations

Gregorio¹,

Gregorio²

2013

JEGH

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“…12,13 A recent issue of the British Medical Journal has brought attention to politics as a determinant of health, and this work begs a theoretical and philosophical framework for understanding the mechanisms through which political institutions impact health. [9][10][11]14,15 One theory that relates political institutions to human development focuses primarily on democratic principles, such as regular elections, universal suffrage, representation, one person-one vote, multiparty competition, and civil liberties. 16 In this realm of thinking, representative democracy is generally understood to produce competition for popular support among elites who are trying to maintain or win elected office, 17 although some argue that politicians' responsiveness to citizens' needs and concerns has waned in some settings.…”

Section: Political Institutions and Healthmentioning

confidence: 99%

Democracy and health

2005

QJM

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“…Some studies have shown that people who live in more democratic societies, which were assumed to empower people with more autonomy, have longer life expectancies and lower mortality rates than do people who live in more autocratic societies; other studies have shown that democracy has little or no effect on mortality rates among the poor [7,8,17]. For example, South Africa became a representative democracy in 1994, but it has shown worsening health indicators ever since [18]. Reviews of the influence of democracy on population health over time have not only been intriguing [10], but have hypothesized and proven that democracy has real and important effects on the daily lives and well-being of individuals around the globe [8,10].…”

Section: Introductionmentioning

confidence: 99%