title: Democracy and self-rated health across 67 countries: A multilevel analysis.
abstract: Existing research has found a positive association between countries' level of democratic governance and the health of their populations, although that research is limited by the use of data from small numbers of high-income countries or aggregate data that do not assess individual-level health outcomes. We extend prior research by using multilevel World Health Survey (2002-2004) data on 313,554 individuals in 67 countries, and find that the positive association between democratic governance and self-rated health persists after adjusting for both individual- and country-level confounders. However, the mechanisms linking democracy and self-rated health remain unclear. Individual-level measures of socioeconomic status, and country-level measures of economic inequality and investments in public health and education, do not significantly mediate the association between democratic governance and self-rated health. The persistent association between democratic governance and health suggests that the political organization of societies may be an important upstream determinant of population health.
authors.affiliation: Department of Health & Behavioral Sciences, University of Colorado Denver | Anschutz Medical Campus, Denver, CO 80217, USA; Population Program, Institute of Behavioral Sciences, University of Colorado Boulder, Boulder, CO 80309, USA. Electronic address: Patrick.Krueger@ucdenver.edu.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Krueger
authors.affiliation: Department of Health & Behavioral Sciences, University of Colorado Denver | Anschutz Medical Campus, Denver, CO 80217, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dovel
authors.affiliation: Department of Sociology, Rice University, Houston, TX 77251, USA.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Denney
mesh_terms: D000328:Adult; D003709:Democracy; D059026:Diagnostic Self Evaluation; D005260:Female; D014943:Global Health; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D055361:Multilevel Analysis; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Corruption; Democracy; Global health; Political epidemiology; Self-rated health; World health survey