Navarro V, Shi L
Department of Health Policy and Management, Johns Hopkins University, 624 North Broadway, Hampton House, Room 448, Baltimore, MD 21205, USA.
Int J Health Serv. 2001;31(1):1-21. doi: 10.2190/1GY8-V5QN-A1TA-A9KJ.
This analysis reflects on the importance of political parties, and the policies they implement when in government, in determining the level of equalities/inequalities in a society, the extent of the welfare state (including the 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 golden years of capitalism (1945-1980)--social democratic, Christian democratic, liberal, and ex-fascist--in four areas: (1) the main determinants of income inequalities; (2) levels of public expenditures and health care benefits coverage; (3) public support of services to families; and (4) the level of population health as measured by infant mortality. The results indicate that political traditions more committed to redistributive policies (both economic and social) and full-employment policies, such as the social democratic parties, were generally more successful in improving the health of populations. The erroneous assumption of a conflict between social equity and economic efficiency is also discussed. The study aims at filling a void in the growing health and social inequalities literature, which rarely touches on the importance of political forces in influencing inequalities.
本分析反思了政党及其执政时所实施政策在决定社会平等/不平等程度、福利国家范围（包括国家医疗保健覆盖水平）、就业/失业率以及人口健康水平方面的重要性。该研究考察了资本主义黄金时期（1945 - 1980年）经合组织发达国家中的主要政治传统——社会民主主义、基督教民主主义、自由主义和前法西斯主义——在四个领域的影响：（1）收入不平等的主要决定因素；（2）公共支出水平和医疗保健福利覆盖范围；（3）对家庭服务的公共支持；（4）以婴儿死亡率衡量的人口健康水平。结果表明，更致力于（经济和社会）再分配政策及充分就业政策的政治传统，如社会民主党，在改善人口健康方面通常更成功。还讨论了关于社会公平与经济效率之间冲突的错误假设。该研究旨在填补日益增多的健康与社会不平等文献中的空白，这些文献很少涉及政治力量在影响不平等方面的重要性。
