title: The Effect of Empowerment and Self-Determination on Health Outcomes.
abstract: There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom House's ratings of country's political rights and civil liberties, while controlling for per capita gross domestic product, secondary school enrollment, and income inequality, on national health outcomes. Using data from 1970 to 2013 across 149 countries, our results suggest, quite strongly, that higher levels of empowerment have a significant positive association with life expectancy, particularly for females, and lower rates of infant and under-five mortality. Our results point to the need for efforts to stimulate economic growth be accompanied with reforms to increase the levels empowerment through increasing political rights and civil liberties.
authors.affiliation: University of Otago, Dunedin, New Zealand arlene.ozanne@otago.ac.nz.
authors.forename: Arlene
authors.initials: A
authors.lastname: Garces-Ozanne
authors.affiliation: University of New Brunswick, Fredericton, New Brunswick, Canada.
authors.forename: Edna Ikechi
authors.initials: EI
authors.lastname: Kalu
authors.affiliation: University of Otago, Dunedin, New Zealand.
authors.forename: Richard
authors.initials: R
authors.lastname: Audas
mesh_terms: D000328:Adult; D046688:Child Mortality; D002675:Child, Preschool; D002961:Civil Rights; D016208:Databases, Factual; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008017:Life Expectancy / Q000639:trends; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D011057:Politics; D011203:Poverty; D011209:Power, Psychological; D064890:Social Determinants of Health / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014480:United Nations; D055815:Young Adult
keywords: empowerment; global health; health disparities; international health; quantitative methods; social determinants