The political context of social inequalities and health

This analysis reflects on the importance of political parties, and the poli cies they implement when in government, in determining the level of equalit ies/inequalities in a society, the extent of the welfare state (including t he level of health care coverage by the state), the employment/unemployment rate, and the level of population health. The study looks at the impact of the major political traditions in the advanced OECD countries during the g olden years of capitalism (1945-1980) - social democratic, Christian democr atic, liberal, and ex-fascist - in four areas: (1) the main determinants of income inequalities, such as the overall distribution of income derived fr om capital versus labor, wage dispersion in the labor force, the redistribu tive effect of the welfare state, and the levels and types of employment/un employment; (2) levels of public expenditures and health care benefits cove rage; (3) public support of services to families, such as child care and do miciliary care; and (4) the level of population health as measured by infan t mortality rates. The results indicate that political traditions more comm itted to redistributive policies (both economic and social) and full-employ ment policies, such as the social democratic parties, were generally more s uccessful in improving the health of populations, such as reducing infant m ortality. The erroneous assumption of a conflict between social equity and economic efficiency, as in the liberal tradition, is also discussed. The st udy aims at filling a void in the growing health and social inequalities li terature, which rarely touches on the importance of political forces in inf luencing inequalities. The data used in the study are largely from OECD hea lth data for 1997 and 1998; the OECD statistical services; the comparative welfare state data set assembled by Huber, Ragin and Stephens; and the US B ureau of Labor Statistics. (C) 2001 Elsevier Science Ltd. All rights reserv ed.