Does Democracy Lead To Better Health?

A released report from V-Dem reveals a rather interesting insight on the global state of health. From their data analysis, it appears that democracies win against autocracies when it comes to producing positive health outcomes.

An unexpected link?

The V-Dem Annual Democracy Report 2019 is the recent edition of the annual report based on the Varieties of Democracy (V-Dem) data set, a growing collection of democracy data. Currently, it spans from 1789 to 2018. The time-series data now possesses 27 million data points.

In V-Dem’s examination of the 1900-2012 data set, it’s revealed that taking other important factors such as good governance into account, democratic elections have consistent effects on the status of a country’s health sector.

Similarly, a study from Bollyky et al. also used the V-Dem data set. The analysis revealed that compared to autocracies, democracies are more likely to lead to health gains for causes of death which are not focused on by foreign aid or those that require health delivery infrastructure. Some of the causes of death which fall under this specification include:

  • cardiovascular diseases
  • transport injuries.
  • tuberculosis
  • non-communicable diseases

While this may be a good thing, why does a particular type of government affect the state of a country’s health?

Where democracies succeed

The reason why democracies have significantly higher health gains than autocracies for the health issues specified above is because those issues need quality health care as well as policy-based prevention in order to be fully addressed. These are things that cannot be directly solved by foreign funding.

Bollyky and his peers proposed that a democratic regime is more open to feedback from constituents and are actually willing to use this feedback to improve healthcare services. Because media freedom is protected in democracies, the dissemination of health information is also easier.

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They also said that the attributes of a democratic government — suffrage, freedom of expression, and freedom of association — compels heightened accountability and responsiveness.

A political affair

In conclusion, the study of Bollyky and his coauthors suggest that democratic governance might be a way to enhance population health.

This is clearly an idea that not everyone will welcome, especially in the context of health which is perceived to be rational and metric-driven. Why make health a political matter now?

If one would look into it closely, health is inherently political. The state has an undeniable role in responding to the interests of the collective. Denying the political nature of health according to Bollyky and his peers would also be to deny the role of society, free media, and a receptive and accountable government in improving the health sector. In other words, health and politics are quite inseparable.

If one is not ready to accept this conclusion in favour of democracies, then at the very least, the recognition of what needs to be done in order to boost healthcare systems should be acknowledged — there is a need to hear the voices of the stakeholders, there should be strong infrastructure, and there should be accountability.

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