1. Politics and Health Outcomes Vicente Navarro, Carles Muntaner, Carme Borrell, Joan Benach, Águeda Quiroga, Maica Rodríguez-Sanz, Núria Vergés, M Isabel Pasarín Lancet 2006; 368: 1033–37 Presented by: Nayan Krishna Joshi

2. I. Background Politics determine public policy including health policy, so one could expect the linkage between politics and health outcome. However the literature linking health with politics is scare but emerging. Mechanisms: a.Political traditions influence health outcomes through their specific welfare state and labor market policies. b. Power resources such as trade unions influence health outcomes by acting on the labor market and on the welfare state through social transfers, such as pensions and social and health care services measured by public social transfers, public health care expenditure, public health benefits coverage etc.

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4. II. Objectives To find out whether different political traditions have been associated with systematic patterns in population health over time. Identifies four different political traditions : 1. Social Democratic 2. Christian Democratic 3. Liberal Parties 4. Conservative Dictatorship OECD countries (for the period1969-1996) were assigned to each of the four political traditions on the basis of redistributive policies (Huber and Stephens’ approach).Huber and Stephens’ approach

6. III. Methodology Political variables: (a)voter participation (percentage of the electorate that voted). (b)voter partisanship (percentage of the vote that went to parties of each of the four different political traditions). (c) time in government by political parties belonging to each tradition. The variable of time in government by each party was constructed with Huber and Stephens’ criteria, and was scored 1 for each year when each party governed alone; for coalition governments, it was scored as that party’s seats in parliament as a fraction of all governing parties’ seats. Measures of social inequality were based on the Theil index (takes a value from 0 to 1, the lower is better), Income distribution is represented using the Gini coefficient (takes a value from 0 to 1, the lower is better) Data Sources: OECD, WHO

7. IV. Results Table 1: Correlation between dependent variable (infant mortality rate) and independent variables for six-cross sectional years

8. IV. Results  Redistributive policies are positively associated with health outcomes.  Long periods of government by pro-redistributive parties are associated with low infant mortality.  Implementation of policies designed to reduce social inequality was associated with low rates of infant mortality.  They also find redistributive policies to be important in but, to a lesser degree, in increasing life expectancy. Further there is an insignificant negative relationship between income inequality and life expectancy, for both women and men.

9. T Table 2: Correlation between dependent variable (life expectancy at birth for women and men) and independent variables for six-cross sectional yr

10. V. The Economics Pigou–Dalton principlePigou–Dalton principle : Argues that that a transfer of income from a richer to a poorer person, so long as that transfer does not reverse the ranking of the two (the initially richer person is not made poorer than the initially poorer person: they are brought together and not switched), will result in greater equity. So, redistributive policies have a positive effect on health outcome. Relation with politics: Political parties with egalitarian ideologies tend to implement redistributive policies. This explains why health indicators such as infant mortality are better in countries that have been governed by pro-redistributive political parties.

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