Health and historical levels of freedom

Samantha L. Biggs, Evelyn M. Dell, Vanessa L. Dixon, Michel R. Joffres, Christopher Beyrer, Kumanan Wilson, James J. Orbinski, Mills J. Edward

Research output: Contribution to journalArticle

Abstract

Background: The link between political freedom and health is unclear. We aimed to determine the association by exploring the relationship of historical and cumulative freedom levels with important health outcomes.Methods: We obtained countrywide health indicators for life expectancy, infant mortality, maternal mortality ratio, % low birth weight babies, Gini coefficient (a measure of wealth inequality) and various markers of freedom based on political rights and civil liberties. We applied multivariable logistic regression to examine the association between health indicators and within-country years of freedom as determined by Freedom House rankings.Results: The total proportion of free years from 1972-2005, the duration of current freedom level, and the Gini coefficient show independent positive associations with health indicators, which remain after the adjustment for national wealth, total government expenditure, and spending on health. Countries identified as having high total proportion of free years demonstrated significantly better health outcomes than countries with low levels of freedom (life expectancy, Odds Ratio [OR] 7.2, 95% Confidence Interval [CI], 2.3-22.6, infant mortality OR 19.6, 95% CI, 5.6-67.7, maternal mortality ratio, OR 24.3, 95% CI, 6.2-94.9, and % low birth weight babies OR 3.8, 95% CI, 1.4-10.8). This was also the case for infant mortality (OR 3.4, 95% CI, 1.0-8.4), maternal mortality ratio (OR 4.0, 95% CI, 1.2-12.8), and % low birth weight babies (OR 2.6, 95% CI, 1.0-6.6) among countries considered as having medium levels of freedom.Interpretation: We found strong associations between country-level freedom and important health outcomes. The cumulative level of freedom over time shows stronger associations with all health indicators than the duration of current freedom level.

Original languageEnglish (US)
Article number11
JournalGlobalization and Health
Volume6
DOIs
StatePublished - May 29 2010

Fingerprint

Health Status
Odds Ratio
Health
Confidence Intervals
Maternal Mortality
Infant Mortality
Low Birth Weight Infant
Life Expectancy
Civil Rights
Health Expenditures
Logistic Models

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Biggs, S. L., Dell, E. M., Dixon, V. L., Joffres, M. R., Beyrer, C., Wilson, K., ... Edward, M. J. (2010). Health and historical levels of freedom. Globalization and Health, 6, [11]. https://doi.org/10.1186/1744-8603-6-11

Health and historical levels of freedom. / Biggs, Samantha L.; Dell, Evelyn M.; Dixon, Vanessa L.; Joffres, Michel R.; Beyrer, Christopher; Wilson, Kumanan; Orbinski, James J.; Edward, Mills J.

In: Globalization and Health, Vol. 6, 11, 29.05.2010.

Research output: Contribution to journalArticle

Biggs, SL, Dell, EM, Dixon, VL, Joffres, MR, Beyrer, C, Wilson, K, Orbinski, JJ & Edward, MJ 2010, 'Health and historical levels of freedom', Globalization and Health, vol. 6, 11. https://doi.org/10.1186/1744-8603-6-11
Biggs SL, Dell EM, Dixon VL, Joffres MR, Beyrer C, Wilson K et al. Health and historical levels of freedom. Globalization and Health. 2010 May 29;6. 11. https://doi.org/10.1186/1744-8603-6-11
Biggs, Samantha L. ; Dell, Evelyn M. ; Dixon, Vanessa L. ; Joffres, Michel R. ; Beyrer, Christopher ; Wilson, Kumanan ; Orbinski, James J. ; Edward, Mills J. / Health and historical levels of freedom. In: Globalization and Health. 2010 ; Vol. 6.
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