Welfare state matters: A typological multilevel analysis of wealthy countries
Welfare state matters: A typological multilevel analysis of wealthy countries
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DOI：
10.1016/j.healthpol.2006.03.004
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发表时间：
2007-02-01
期刊：
影响因子：
3.3
通讯作者：
Muntaner, Carles
中科院分区：
文献类型：
--
作者：
Chung, Haejoo;Muntaner, Carles
基于社会科学文献，我们假设富裕工业化国家的人口健康指标围绕福利国家制度类型“聚集”。我们在1960年至1994年的福利国家扩张期间检验了这一假设。我们将来自19个富裕国家的数据分为4种不同类型的福利国家制度（社会民主党，基督教民主党，自由党和工薪阶层福利国家）。结果变量是婴儿死亡率和低出生体重率，数据来自经济合作与发展组织（经合组织）2000年健康数据和联合国共同统计数据库。构建了一个两水平的多水平模型，并检验了福利国家的固定效应。在分析的39年中，社会民主党国家的人口健康状况明显更好，即，与其他国家相比，婴儿死亡率和出生体重不足率较低。各国婴儿死亡率的差异有20%可以用福利国家的类型来解释，约10%可以用低出生体重率来解释。1990年代，社会民主国家与其他国家之间的差距扩大了。我们的研究结果证实，国家表现出不同的福利制度类型的人口健康水平，即使调整的经济发展水平（人均GDP）和国内相关性。这意味着各国作为一个集团，采取类似的政策或通过任何其他方式，实现类似的健康状况。在讨论中提出了这种过程的机制和未来的研究方向的建议。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Building on the social science literature, we hypothesized that population health indicators in wealthy industrialized countries are 'clustered' around welfare state regime types. We tested this hypothesis during a period of welfare state expansion from 1960 to 1994. We categorized data from 19 wealthy countries into 4 different types of welfare state regimes (Social Democratic, Christian Democratic, Liberal and Wage Earner Welfare States). Outcome variables were the infant mortality rate (IMR) and the low birth weight rate (LBW), obtained from the Organization of Economic Co-operation and Development (OECD) Health Data 2000 and from the United Nations Common Statistical Database (UNCSD). A two-level multilevel model was constructed, and fixed effects of welfare state were tested. Through the 39 years analyzed, Social Democratic countries exhibited a significantly better population health status, i.e., lower infant mortality rate and low birth weight rate, compared to other countries. Twenty percent of the difference in infant mortality rate among countries could be explained by the type of welfare state, and about 10% for low birth weight rate. The gap between Social Democracies and other countries widened over the 1990s. Our results confirm that countries exhibit distinctive levels of population health by welfare regime types even when adjusted by the level of economic development (GDP per capita) and intra-country correlations. It implies that countries, as groups, adopt similar policies or through any other ways, achieve similar level of health status. Proposed mechanisms of such process and suggestions for future research directions are presented in the discussion. (c) 2006 Elsevier Ireland Ltd. All rights reserved.