Political economy and population health: from theory to an empirical assessment of the impact of austerity on mortality trends

McCartney, Gerard (2022) Political economy and population health: from theory to an empirical assessment of the impact of austerity on mortality trends. PhD thesis, University of Glasgow.

Abstract

The life expectancy of most high income countries had increased consistently over the second half of the 20th Century. However, after around 2012 these improving trends stalled in many countries. This thesis seeks to explain these trends through a political economy lens.

There are three central arguments made in this thesis. First, that health is best defined as a structural, functional and emotional state that is compatible with effective life as an individual and as a member of society; and that health inequalities are best defined as the systematic, avoidable and unfair differences in health outcomes that can be observed between populations, between social groups within the same population, or as a gradient across a population ranked by social position.

Second, that political economy is crucial to understanding the health of populations. The existing evidence linking political economy to population health was systematically reviewed and synthesised. Although there were risks of bias, social democratic welfare states, higher public spending, fair trade policies, extensions to compulsory education provision, microfinance initiatives in low-income countries, health and safety policy, improved access to health care, and high-quality affordable housing were found to have positive impacts on population health. ‘Neoliberal’ restructuring was associated with increased health inequalities. Higher income inequality was associated with lower self-rated health and higher mortality.

Third, countries with more austere policy in recent decades experienced slower improvements in mortality, especially when measured as changes in Government Expenditure and Public Social Spending, and when implemented during economic downturns, albeit with imprecise effect estimates. The stalled mortality trends observed across many high income countries is therefore likely to be at least partly due to austerity policies.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: H Social Sciences > HB Economic Theory; J Political Science > JA Political science (General)
• Colleges/Schools: College of Social Sciences > Adam Smith Business School > Management
• Supervisor's Name: McMaster, Professor Robert, Popham, Dr. Frank and Dundas, Professor Ruth
• Date of Award: 2022
• Depositing User: Theses Team
• Unique ID: glathesis:2022-83260
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 14 Nov 2022 14:41
• Last Modified: 14 Nov 2022 16:36
• Thesis DOI: 10.5525/gla.thesis.83260
• URI: https://theses.gla.ac.uk/id/eprint/83260

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