Social Science and Health Research, Centre for Addiction and Mental Health (CAMH) and Global Health Program, University of Toronto, Toronto, Ontario, Canada.
Sociol Health Illn. 2011 Sep;33(6):946-64. doi: 10.1111/j.1467-9566.2011.01339.x.
In recent years, a research area has emerged within social determinants of health that examines the role of politics, expressed as political traditions/parties and welfare state characteristics, on population health. To better understand and synthesise this growing body of evidence, the present literature review, informed by a political economy of health and welfare regimes framework, located 73 empirical and comparative studies on politics and health, meeting our inclusion criteria in three databases: PubMed (1948-), Sociological Abstracts (1953-), and ISI Web of Science (1900-). We identified two major research programmes, welfare regimes and democracy, and two emerging programmes, political tradition and globalisation. Primary findings include: (1) left and egalitarian political traditions on population health are the most salutary, consistent, and substantial; (2) the health impacts of advanced and liberal democracies are also positive and large; (3) welfare regime studies, primarily conducted among wealthy countries, find that social democratic regimes tend to fare best with absolute health outcomes yet consistently in terms of relative health inequalities; and (4) globalisation defined as dependency indicators such as trade, foreign investment, and national debt is negatively associated with population health. We end by discussing epistemological, theoretical, and methodological issues for consideration for future research.
近年来,健康的社会决定因素领域出现了一个研究方向,探讨政治(表现为政治传统/党派和福利国家特征)对人口健康的影响。为了更好地理解和综合这一日益增长的证据,本文献综述以健康的政治经济学和福利制度框架为指导,在三个数据库中确定了 73 项关于政治与健康的实证和比较研究,这些研究符合我们的纳入标准:PubMed(1948-)、社会学文摘(1953-)和 ISI Web of Science(1900-)。我们确定了两个主要的研究计划,即福利制度和民主,以及两个新兴的计划,即政治传统和全球化。主要发现包括:(1)对人口健康最有益、最一致和最显著的是左派和平等主义的政治传统;(2)先进和自由民主的健康影响也是积极和巨大的;(3)主要在富裕国家进行的福利制度研究发现,社会民主制度在绝对健康结果方面往往表现最好,但在相对健康不平等方面始终如此;(4)全球化被定义为贸易、外国投资和国债等依存指标与人口健康呈负相关。最后,我们讨论了未来研究需要考虑的认识论、理论和方法论问题。