IDEAS home Printed from https://ideas.repec.org/p/ehl/lserod/119444.html
   My bibliography  Save this paper

Does exposure to democracy decrease health inequality?

Author

Listed:
  • Costa-Font, Joan
  • Knust, Niklas

Abstract

Exposure to (a liberal) democracy can have an impact on both the political attention and visibility of the needs of marginalized populations, as well as the design of health policies that can influence the distribution of population health. This paper investigates the effect of exposure to democracy, that is, the number of years spent in a democracy as measured by democracy indexes, on various measures of inequality in self-reported health across European countries. We use an instrumental variable strategy to leverage the potential endogeneity of a country's exposure to democracy, drawing on both bivariate (socioeconomic) and univariate health inequality measures. Our estimates provide evidence that an additional year in a democracy reduces both bivariate (income-related) health inequality and overall (univariate) health inequality. Our preferred specification suggests a two-point rank reduction in inequality with an additional year under a democracy. The effect is mainly driven by a reduction of "health poverty"alongside other effects.

Suggested Citation

  • Costa-Font, Joan & Knust, Niklas, 2023. "Does exposure to democracy decrease health inequality?," LSE Research Online Documents on Economics 119444, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:119444
    as

    Download full text from publisher

    File URL: http://eprints.lse.ac.uk/119444/
    File Function: Open access version.
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Michael Ross, 2006. "Is Democracy Good for the Poor?," American Journal of Political Science, John Wiley & Sons, vol. 50(4), pages 860-874, October.
    2. Alberto Batinti & Joan Costa‐Font & Timothy J. Hatton, 2022. "Voting Up? The Effects of Democracy and Franchise Extension on Human Stature," Economica, London School of Economics and Political Science, vol. 89(353), pages 161-190, January.
    3. Joan Costa-Font & Frank A. Cowell, 2022. "The measurement of health inequalities: does status matter?," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 20(2), pages 299-325, June.
    4. Paola Giuliano & Prachi Mishra & Antonio Spilimbergo, 2013. "Democracy and Reforms: Evidence from a New Dataset," American Economic Journal: Macroeconomics, American Economic Association, vol. 5(4), pages 179-204, October.
    5. Acemoglu, Daron & Johnson, Simon & Robinson, James A., 2005. "Institutions as a Fundamental Cause of Long-Run Growth," Handbook of Economic Growth, in: Philippe Aghion & Steven Durlauf (ed.), Handbook of Economic Growth, edition 1, volume 1, chapter 6, pages 385-472, Elsevier.
    6. Torsten Persson & Guido Tabellini, 2009. "Democratic Capital: The Nexus of Political and Economic Change," American Economic Journal: Macroeconomics, American Economic Association, vol. 1(2), pages 88-126, July.
    7. Holmberg, Sören & Rothstein, Bo, 2011. "Dying of corruption," Health Economics, Policy and Law, Cambridge University Press, vol. 6(4), pages 529-547, October.
    8. Daron Acemoglu & Suresh Naidu & Pascual Restrepo & James A. Robinson, 2019. "Democracy Does Cause Growth," Journal of Political Economy, University of Chicago Press, vol. 127(1), pages 47-100.
    9. ., 2016. "How can economic inequality influence health?," Chapters, in: Sick of Inequality?, chapter 4, pages 38-47, Edward Elgar Publishing.
    10. Kaufmann, Daniel & Kraay, Aart & Mastruzzi, Massimo, 2007. "The worldwide governance indicators project : answering the critics," Policy Research Working Paper Series 4149, The World Bank.
    11. Mark Gradstein & Branko Milanovic, 2004. "Does Libertè = Egalité? A Survey of the Empirical Links between Democracy and Inequality with Some Evidence on the Transition Economies," Journal of Economic Surveys, Wiley Blackwell, vol. 18(4), pages 515-537, September.
    12. Powell-Jackson, Timothy & Basu, Sanjay & Balabanova, Dina & McKee, Martin & Stuckler, David, 2011. "Democracy and growth in divided societies: A health-inequality trap?," Social Science & Medicine, Elsevier, vol. 73(1), pages 33-41, July.
    13. Robert J. Barro, 1999. "Determinants of Democracy," Journal of Political Economy, University of Chicago Press, vol. 107(S6), pages 158-183, December.
    14. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    15. Timothy Besley & Masayuki Kudamatsu, 2006. "Health and Democracy," American Economic Review, American Economic Association, vol. 96(2), pages 313-318, May.
    16. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, April.
    17. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    18. Frank A. Cowell & Emmanuel Flachaire, 2017. "Inequality with Ordinal Data," Economica, London School of Economics and Political Science, vol. 84(334), pages 290-321, April.
    19. Klomp, Jeroen & de Haan, Jakob, 2009. "Is the political system really related to health?," Social Science & Medicine, Elsevier, vol. 69(1), pages 36-46, July.
    20. Lipset, Seymour Martin, 1959. "Some Social Requisites of Democracy: Economic Development and Political Legitimacy1," American Political Science Review, Cambridge University Press, vol. 53(1), pages 69-105, March.
    21. John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
    22. Matsuura, H., 2015. "State constitutional commitment to health and health care and population health outcomes: Evidence from historical US data," American Journal of Public Health, American Public Health Association, vol. 105, pages 48-54.
    23. Krueger, Patrick M. & Dovel, Kathryn & Denney, Justin T., 2015. "Democracy and self-rated health across 67 countries: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 143(C), pages 137-144.
    24. Daron Acemoglu & Suresh Naidu & Pascual Restrepo & James A. Robinson, 2013. "Democracy, Redistribution and Inequality," NBER Working Papers 19746, National Bureau of Economic Research, Inc.
    25. Owen O’Donnell & Stephen O’Neill & Tom Van Ourti & Brendan Walsh, 2016. "conindex: Estimation of concentration indices," Stata Journal, StataCorp LP, vol. 16(1), pages 112-138, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Federico Maggio & Dominic Rohner & Alessandro Saia, 2024. "The Democracy Dividend: ˗How Early Exposure to Democracy Shapes Health Outcomes˗," CESifo Working Paper Series 11307, CESifo.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alberto Batinti & Joan Costa‐Font & Timothy J. Hatton, 2022. "Voting Up? The Effects of Democracy and Franchise Extension on Human Stature," Economica, London School of Economics and Political Science, vol. 89(353), pages 161-190, January.
    2. Joan Costa-Font & Frank A. Cowell, 2022. "The measurement of health inequalities: does status matter?," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 20(2), pages 299-325, June.
    3. Méon, Pierre-Guillaume & Sekkat, Khalid, 2022. "A time to throw stones, a time to reap: how long does it take for democratic transitions to improve institutional outcomes?," Journal of Institutional Economics, Cambridge University Press, vol. 18(3), pages 429-443, June.
    4. Daron Acemoglu & Suresh Naidu & Pascual Restrepo & James A. Robinson, 2019. "Democracy Does Cause Growth," Journal of Political Economy, University of Chicago Press, vol. 127(1), pages 47-100.
    5. Kammas, Pantelis & Sarantides, Vassilis, 2019. "Do dictatorships redistribute more?," Journal of Comparative Economics, Elsevier, vol. 47(1), pages 176-195.
    6. Welander, Anna & Lyttkens, Carl Hampus & Nilsson, Therese, 2015. "Globalization, democracy, and child health in developing countries," Social Science & Medicine, Elsevier, vol. 136, pages 52-63.
    7. Ọláyínká Oyèkọ́lá, 2023. "Democracy Does Improve Health," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 166(1), pages 105-132, February.
    8. Jorge Braga Macedo & Joaquim Oliveira Martins & João Tovar Jalles, 2021. "Globalization, Freedoms and Economic convergence: an empirical exploration of a trivariate relationship using a large panel," International Economics and Economic Policy, Springer, vol. 18(3), pages 605-629, July.
    9. Nedra Baklouti & Younes Boujelbene, 2018. "The Nexus Between Democracy and Economic Growth: Evidence from Dynamic Simultaneous-Equations Models," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 9(3), pages 980-998, September.
    10. van der Windt, Peter & Vandoros, Sotiris, 2017. "Democracy and health: Evidence from within-country heterogeneity in the Congo," Social Science & Medicine, Elsevier, vol. 194(C), pages 10-16.
    11. Gundlach, Erich & Paldam, Martin, 2009. "A farewell to critical junctures: Sorting out long-run causality of income and democracy," European Journal of Political Economy, Elsevier, vol. 25(3), pages 340-354, September.
    12. Hyungmin Park, 2024. "Theory of developmental dictatorship," Discussion Papers 2024-10, Nottingham Interdisciplinary Centre for Economic and Political Research (NICEP).
    13. Dorsch, Michael T. & Maarek, Paul, 2019. "Democratization and the Conditional Dynamics of Income Distribution," American Political Science Review, Cambridge University Press, vol. 113(2), pages 385-404, May.
    14. Gutmann, Jerg & Voigt, Stefan, 2018. "The rule of law: Measurement and deep roots," European Journal of Political Economy, Elsevier, vol. 54(C), pages 68-82.
    15. Fuchs-Schündeln, N. & Hassan, T.A., 2016. "Natural Experiments in Macroeconomics," Handbook of Macroeconomics, in: J. B. Taylor & Harald Uhlig (ed.), Handbook of Macroeconomics, edition 1, volume 2, chapter 0, pages 923-1012, Elsevier.
    16. Vollmer, Sebastian & Ziegler, Maria, 2009. "Political Institutions and Human Development Does Democracy Fulfill its 'Constructive' and 'Instrumental' Role?," Policy Research Working Paper Series 4818, The World Bank.
    17. Christopher A. Hartwell & Roman Horvath & Eva Horvathova & Olga Popova, 2019. "Democratic Institutions, Natural Resources, and Income Inequality," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 61(4), pages 531-550, December.
    18. Kotera, Go & Okada, Keisuke, 2015. "How Does Democratization Affect the Composition of Government Expenditure?," MPRA Paper 67085, University Library of Munich, Germany.
    19. Matteo Cervellati & Piergiuseppe Fortunato & Uwe Sunde, 2008. "Hobbes to Rousseau: Inequality, Institutions and Development," Economic Journal, Royal Economic Society, vol. 118(531), pages 1354-1384, August.
    20. Johannes Blum & Florian Dorn & Axel Heuer, 2021. "Political institutions and health expenditure," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 28(2), pages 323-363, April.

    More about this item

    Keywords

    health inequality; income-related health inequality; Europe; democracy; institutions; health poverty;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ehl:lserod:119444. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: LSERO Manager (email available below). General contact details of provider: https://edirc.repec.org/data/lsepsuk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.