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Diseases of commerce: Unbundling economic freedom and public health

Author

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  • Geloso, Vincent
  • Hyde, Kelly
  • Murtazashvili, Ilia

Abstract

We explore the institutional foundations of public health by distinguishing among three broad categories of disease: diseases of poverty, which are income-sensitive and decline with improved living standards; diseases of commerce, which are contact-transmissible and spread with mobility and exchange; and diseases of affluence, which are longevity-mediated noncommunicable conditions such as cancer, heart disease, and diabetes that become more prevalent as people live longer. This classification allows us to examine how economic freedom, through its effects on income, mobility, and survival, reshapes the mix of disease rather than health outcomes in aggregate. Using global health data, we find that economically free societies experience large reductions in diseases of poverty, modest changes in diseases of commerce, and a higher relative share of diseases of affluence even as total age-standardized mortality declines. These results reveal that institutional arrangements influence the composition of mortality more than its overall level: economic freedom enhances prosperity and resilience while shifting the burden of disease toward conditions associated with longer lives.

Suggested Citation

  • Geloso, Vincent & Hyde, Kelly & Murtazashvili, Ilia, 2026. "Diseases of commerce: Unbundling economic freedom and public health," Journal of Economic Behavior & Organization, Elsevier, vol. 243(C).
    • Handle: RePEc:eee:jeborg:v:243:y:2026:i:c:s016726812600048x
    DOI: 10.1016/j.jebo.2026.107460
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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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