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December 17, 2004

Effect of democracy on health: ecological study

Topics: International News

The BMJ (2004;329:1421-1423;18 December) has published an ecological study, by Álvaro Franco of Universidad de Alicante, which undertakes to measure if democracy is good for your health. The authors findings might come as a surprise to those who are not supporters of the  mantra of President Bush and most conservatives that freedom and democracy are good for everyone including there health (in many cases literally life or death).

The authors of the the BMJ article created a database from countries with data available on per capita gross national product, total government expenditure, the Gini coefficient, freedom ratings, life expectancy, and maternal and infant mortality. They obtained information from the Human Development Report and publications of the International Monetary Fund and Freedom House. All data relate to 1998.

Their final sample represents 98% of the world's population in 170 countries--75% of the countries and territories of the world, and 85% of those in the United Nations. Overall, 45% of the countries were free, 32% partially free, and 24% not free. Around 61% of the world's inhabitants are therefore exposed to lack of freedom by living in partially free countries (29%) or not free (32%) countries. For their sample they had available data on freedom ratings and gross national product. They obtained data on life expectancy for 158 countries, on infant mortality for 162 countries, and on maternal mortality for 140 countries. Some of the more important results are summarized in the following excerpts:

(...)  Democracy shows an independent positive association with health, which remains after adjustment for a country's wealth, its level of inequality, and the size of its public sector.

(...)  Democracy, political rights, and civil liberties are politically modifiable variables that seem to be associated with health status. In our study, democracy showed a stronger and more significant association with indicators of health (life expectancy and infant and maternal mortality) than indicators such as gross national product, total government expenditure, or inequality in income. When all these variables were taken into account, the economic ones lost their weight, thereby increasing the importance of the effect of democracy.

(...)  The health indicators showed a statistically significant relation with freedom ratings: the highest levels of health were in free countries followed by the partially free countries, and the worst levels of health were in countries that were not free. The relation between health indicators and freedom ratings we observed seemed to remain along the stratum of income by countries.

The short form of the results from their study is that "Democracy is good for your health."
Read the article in
Read the excellent comments on the article at Black Triangle...

Posted by Hyscience at December 17, 2004 12:28 PM

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