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Abstract
Economic indicators such as income inequality are gaining attention as putative determinants
of population health. On the other hand, we are just beginning to explore the
health impact on population health of political and welfare state variables such as political
orientation of government or type of medical care coverage. To determine the socially
structured impact of political and welfare state variables on low birth weight rate, infant
mortality rate, and under-five mortality rate, we conducted an ecological study with un
balanced
time-series data from 19 wealthy OECD countries for the years from 1960 to
1994. Among the political/welfare state variables, total public medical coverage was the
most significant predictor of the mortality outcomes. The low birth weight rate was more
sensitive to political predictors such as percentage of vote obtained by social democratic
or labor parties. Overall, political and welfare state variables (including indicators of health
policies) are associated with infant and child health indicators. While a strong medical care
system seems crucial to some population health outcomes (e.g., the infant mortality rate),
other population health outcomes might be impacted by social policies enacted by parties
supporting strong welfare states (the low birth weight rate). Our investigation suggests that
strong political will that advocates for more egalitarian welfare policies, including public
medical services, is important in maintaining and improving the nation’s health. © 2006
Elsevier Ltd. All rights reserved.
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