The Right to Health: Institutional Effects of Constitutional Provisions on Health Outcomes
The Right to Health: Institutional Effects of Constitutional Provisions on Health Outcomes
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DOI：
10.1007/s12116-015-9189-z
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发表时间：
2016-09-01
影响因子：
2.7
通讯作者：
Kavanagh, Matthew M.
中科院分区：
文献类型：
--
作者：
Kavanagh, Matthew M.
“健康权”越来越多地被载入世界各地的国家宪法中——如今，在绝大多数成文宪法中都有体现。这种趋势是好、坏还是毫无意义，人们一直争论不休。与怀疑论者的担忧相反，本研究发现了健康权在人口健康生产中发挥积极作用的经验证据。评估最广泛传播的健康问题经济和社会决定因素理论以及选举民主的作用，为评估健康权的效果提供了基础。这项研究收集并分析了 1970 年至 2010 年间 144 个国家的数据，发现在控制这些因素的情况下，宪法规定的健康权对福祉有重大贡献。收集的定量和案例研究证据都支持这样的观点，即健康权塑造的制度环境鼓励提供更多更好的卫生服务，这在一定程度上解释了对健康结果的积极影响。这些结果表明，主要关注民主参与权的政治制度研究忽视了“权利”对卫生决策规范和行为者的重要影响。总体而言，健康权既是健康研究的重要背景因素，也是有意义的制度创新。
The "right to health" is increasingly enshrined in national constitutions around the world-present today in a slight majority of written constitutions. Whether this trend is good, bad, or meaningless is considerably debated. Contrary to skeptics' worries, this study finds empirical evidence of a positive role of the right to health in the production of population health. Estimating the most widely promulgated theories of the economic and social determinants of health, and the role of electoral democracy, provides a foundation from which to evaluate the effect of the right to health. This study assembles and analyzes data for 144 countries between 1970 and 2010 and finds that, controlling for these factors, a constitutional right to health contributes significantly to wellbeing. Assembled quantitative and case-study evidence both support the idea that institutional environments shaped by a right to health encourage more and better delivery of health services, which in part account for positive impact on health outcomes. These results suggest that focusing research on political institutions primarily on democratic participation rights ignores important impacts of "entitlement" rights on norms and actors in health policy-making. Overall, the right to health is both an important contextual factor for health research and meaningful institutional innovation.