Elsevier

The Lancet

Volume 368, Issue 9540, 16–22 September 2006, Pages 1033-1037
The Lancet

Public Health
Politics and health outcomes

https://doi.org/10.1016/S0140-6736(06)69341-0Get rights and content

Summary

The aim of this study was to examine the complex interactions between political traditions, policies, and public health outcomes, and to find out whether different political traditions have been associated with systematic patterns in population health over time. We analysed a number of political, economic, social, and health variables over a 50-year period, in a set of wealthy countries belonging to the Organisation for Economic Co-operation and Development (OECD). Our findings support the hypothesis that the political ideologies of governing parties affect some indicators of population health. Our analysis makes an empirical link between politics and policy, by showing that political parties with egalitarian ideologies tend to implement redistributive policies. An important finding of our research is that policies aimed at reducing social inequalities, such as welfare state and labour market policies, do seem to have a salutary effect on the selected health indicators, infant mortality and life expectancy at birth.

Section snippets

Political traditions and redistributive policies

Within the group of OECD countries examined in this study, those mainly governed by social democratic parties for the majority of the period under study (1950–2000) are Sweden (for 45 years), Norway (39 years), Denmark (35 years), Finland (32 years), and Austria (31 years).13, 14, 15, 16 (See webpanel for a list of parties.) The social democratic parties in these countries have historically been committed to redistributive policies (the average Gini coefficient in this group over the last 10

Effects of political traditions on health outcomes

Once the countries were thus grouped by political tradition, we analysed the relation between cumulative years of government by each political tradition and changes in two key health outcomes—infant mortality and life expectancy at birth. This analysis was done for the years for which health indicators were available for all countries. It was also restricted to long periods of homogeneous government, since short periods of government might not have a measurable effect on populations' health

Political influence over health outcomes

What are the mechanisms by which ruling political parties determine public policy, including health policy, and in turn influence health outcomes? We devised a heuristic framework (figure) involving pathways from politics, to public policy, income distribution, and the selected health indicators. According to this model, specific welfare state and labour market policies characterise each political tradition, and these are the main mechanisms by which politics acts on health outcomes. Other

Do politics matter in health policy?

Our findings supplement studies in health economics on the effects of redistributive policies on health,22, 23 by adding a political component. Our analysis suggests that political parties with egalitarian ideologies tend to implement redistributive policies. But the connection between ideology, social class constituency, and implementation of particular policies is complex, as can be seen from the fact that, during the past 30 years, many countries governed by social democratic parties have

References (23)

  • D Caramani

    The societies of Europe: elections in western Europe since 1815

    (2000)
  • Cited by (398)

    View all citing articles on Scopus
    View full text