柏林墙倒塌后的民主化与健康
Democratisation and health after the fall of the Wall.
作者信息
Alvarez-Dardet Carlos, Franco-Giraldo Alvaro
机构信息
Department of Public Health, University of Alicante, Spain.
出版信息
J Epidemiol Community Health. 2006 Aug;60(8):669-71. doi: 10.1136/jech.2005.038273.
OBJECTIVES
The fall of the Wall in 1989 can be seen as a natural experiment in the epidemiological sense to further examine the relation between democracy and health.
DESIGN AND SETTING
Ecological study in the 23 post-communist countries, during the last decade of the 20th century, exploring the relations between the level of democratisation and health, taking into account as relevant confounders wealth and the level of inequality.
MAIN RESULTS
A significant correlation (p<0.01) was found of the democratic deficit of the countries with the health indicators circa 2000, with values of Pearson's coefficient of -0.629 for life expectancy, 0.760 for infant mortality, and 0.555 for maternal mortality. These associations remain significant after adjustment by lineal regression for GNP per capita and the Gini coefficient, with R(2) values of 0.336 for life expectancy, 0.575 for infant mortality, and 0.529 for maternal mortality.
CONCLUSIONS
These findings add pieces of evidence to the previously reported cross sectional association between democracy and health.
目的
1989年柏林墙倒塌可视为一项流行病学意义上的自然实验，以进一步探究民主与健康之间的关系。
设计与背景
在20世纪最后十年对23个后共产主义国家进行生态研究，探讨民主化水平与健康之间的关系，同时将财富和不平等程度作为相关混杂因素加以考虑。
主要结果
发现这些国家的民主赤字与2000年左右的健康指标存在显著相关性（p<0.01），皮尔逊系数值分别为：预期寿命-0.629、婴儿死亡率0.760、孕产妇死亡率0.555。在对人均国民生产总值和基尼系数进行线性回归调整后，这些关联依然显著，预期寿命的R(2)值为0.336，婴儿死亡率为0.575，孕产妇死亡率为0.529。
结论
这些发现为先前报道的民主与健康之间的横断面关联增添了证据。
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