Regime Type and Territorial Inequalities in Health Outcomes

• In Event: Regime Type, Regime Evolution, Public Policy, and Human Development

Abstract

Previous research on the relationship between regime type and population health has focused on overall population health (e.g., life expectancy) and the health status of the poorest members of society (as proxied by infant mortality). However, indicators of health for the entire population fail to capture the spatial distribution of mortality and morbidity. Does democracy influence whether equally prosperous or poor regions within a country achieve the same health outcomes? Do the least healthy regions in democracies compare favorably with the least healthy regions in autocracies? With these questions in mind, we examine whether level of democracy at the national level impacts the distribution of health outcomes between regions in each country. By leveraging geospatial data for 99 low- and middle-income countries, we find that the degree of democracy at the national level is associated with less territorial inequality in under-5 mortality. We also examine whether regional health disparities are influenced by the level of local democracy, the autonomy of regional governments, and the electoral system.

Authors

• Thomas J Bollyky, Council on Foreign Relations

• Joseph Dieleman, University of Washington

• Simon Wigley, Bilkent University

• Tara Templin, University of North Carolina