Autocratization and Health Outcomes

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

Abstract

If autocratization, like autocracy, helps political insiders at the expense of political outsiders, it should lead to lower primary health care spending as a share of GDP, less widespread access to quality health services, and higher infant mortality. This paper explores these hypotheses statistically across up to 165 countries observed annually between 1990 and 2019. It finds that autocratization is associated, as predicted, with lower primary health care spending as a share of GDP and, less robustly, with narrower access to quality health care services. In some analyses, however, autocratization is also found to be associated, unexpectedly, with lower infant mortality. Possible explanations for this perplexing result include statistical artifacts, aspects of left- and right-wing ideologies, and government manipulation of infant mortality data. Importantly for future research, many of the paper's findings were sensitive to the autocratization indicator chosen, statistical method used, country cases studied, and time period observed.

Author

• James W. McGuire, Wesleyan University