The Impact of Regime Type on Health: Does Redistribution Explain Everything?

Abstract

Many scholars claim that democracy improves population health. The prevailing explanation for this is that democratic regimes distribute health-promoting resources more widely than autocratic regimes. The central contention of this article is that democracies also have a significant pro-health effect regardless of public redistributive policies. After establishing the theoretical plausibility of the nondistributive effect, a panel of 153 countries for the years 1972 to 2000 is used to examine the relationship between extent of democratic experience and life expectancy. The authors find that democratic governance continues to have a salutary effect on population health even when controls are introduced for the distribution of health-enhancing resources. Data for fifty autocratic countries for the years 1994 to 2007 are then used to examine whether media freedom—independent of government responsiveness—has a positive impact on life expectancy.

Democracy, Redistribution, and Inequality

“…Besley and Kudamatsu (2006) show this in a panel data model for the post-war period but without using country fixed effects. Wigley and Akkoyunlu-Wigley (2011) in a complementary study have shown that life expectancy is positively correlated with the history of democracy of a country. Kudamatsu 2012showed in the context of democratic transitions in Africa that health outcomes improved in countries which democratized compared to those that did not.…”

State or Regime? The Impact of Institutions on Welfare Outcomes

“…There is also substantial empirical evidence that democracy distributes more to its citizens. The findings are robust across sev-eral different outcomes including welfare spending (Brown and Hunter 1999;Lake and Baum 2001;Rudra and Haggard 2005;Huber, Mustillo, and Stephens 2008), education (Brown and Hunter 2000;Stasavage 2005), and public health (Besley and Kudamatsu 2006;Akkoyunlu-Wigley 2011a and2011b). Przeworski et al (2000) treat the subject more expansively, presenting evidence that once democracies and dictatorships reach a developmental threshold, different patterns of production, consumption, and investment lead to superior welfare outcomes in democracies.…”

Mobilizing civil society for the HIV treatment cascade: a global analysis on democracy and its association with people living with HIV who know their status

“…In the context of HIV, studies have shown how greater state capacity is positively associated with lower HIV infection rates , and how democratic conditions increase access to HIV prevention and treatment . Scholars have attributed these findings to how democratic political conditions enable active non‐governmental and citizen participation in healthcare, while according them greater civil liberties , which hold true as in the context of HIV organizational leadership . Nevertheless, several scholars find that regardless of regime type, contextual and historical precedence may impede or facilitate such responses to the epidemic .…”