Are social democracies better for health than right-wing dictatorships : U-M study

ANN ARBOR, Mich.—A University of Michigan study finds that longevity increased faster under right-wing governments in southern Europe than under social democracies in the Nordic countries.

The study, published online in the peer-reviewed journal Social Science and Medicine, examines changes in longevity patterns in eight European countries from 1950 to 2000. The countries studied were Iceland, Norway, Sweden, Denmark, Finland, Greece, Portugal and Spain.

The five Nordic countries were among the richest market economies in Europe during the period studied, governed mostly by center or center-left coalitions, including social democratic parties, and offering generous, universal health and welfare benefits to their citizens. In contrast, the three southern European nations studied were among the poorest in Europe, with fragmented systems of welfare provision and many years of military or authoritarian right-wing rule.

"In spite of the socioeconomic and political differences, and a large gap in 1950 between the five Nordic and three southern nations in levels of health, by 2000 life expectancy at birth converged," said Jose A. Tapia Granados, a researcher at the U-M Institute of Social Research and the author of the study.

"Gains in longevity in Portugal and Spain were almost three times greater than gains in Denmark, and about twice as great as those in Iceland, Norway and Sweden. These findings raise serious doubts about the belief that the type of political regime and the level of health care spending exert major influences on population health."

Identifying the causes of short- or long-term effects on population health is not an easy task, Tapia Granados points out. A number of possible factors could be responsible for the longevity gains in Spain, Greece and Portugal during the 50-year period studied. These include better hygienic practices, advances in education, generalized use of vaccines and antibiotics, improvements in sanitary infrastructures and enhancement of caloric intake. But since the Nordic countries were better off in all these factors, Tapia Granados notes, they cannot explain the faster advance in the southern countries.

A biological limit to human longevity could explain the convergence. However most demographers believe there is no such limit, says Tapia Granados. Furthermore, data show that in Denmark, for instance, mortality of the elderly in recent years is significantly higher than in the other countries in the sample.

The article suggests some factors that may explain why the five Nordic countries experienced slower gains in life expectancy. For instance, during the 1950s and 1960s, tobacco consumption in Denmark was three or four times higher than in Spain and Portugal. Also, the Mediterranean diet of low-calorie, mainly vegetarian content prevalent in the southern countries is also known to promote health.

"It could also be that working conditions in the Nordic countries are more stressful, since labor markets there are more flexible," said Tapia Granados. "That means workers are fired more frequently, which tends to be associated with worse health. A reduced level of social support due to smaller family sizes in the Nordic countries also could be a factor promoting health in the southern countries, where families were larger.

"Regardless of whether the true causal factors can be reliably identified, the complexity of the determinants of mortality trends suggests that recent claims regarding the influence of political parties or party politics on health outcomes are likely to be overstated. This does not negate the impact of social or economic policy on population health, but rather warns against simplistic or partisan explanations that attribute causality to particular political regimes or parties in power.

"There are many good reasons to reject authoritarian regimes and support equalitarian policies, but the impact of these regimes on population health does not appear to be a compelling one."

Established in 1949, the University of Michigan Institute for Social Research is the world’s largest academic social science survey and research organization, and a world leader in developing and applying social science methodology, and in educating researchers and students from around the world. ISR conducts some of the most widely cited studies in the nation, including the Thomson Reuters/University of Michigan Survey of Consumer Attitudes, the American National Election Studies, the Monitoring the Future Study, the Panel Study of Income Dynamics, the Health and Retirement Study, the Columbia County Longitudinal Study and the National Survey of Black Americans. ISR researchers also collaborate with social scientists in more than 60 nations on the World Values Surveys and other projects, and the institute has established formal ties with universities in Poland, China and South Africa. ISR is also home to the Inter-University Consortium for Political and Social Research, the world’s largest digital social science data archive. Visit the ISR website at for more information.

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