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

[Editor’s note: The headline in this story has been changed to reflect Professor Tapia’s preferences. For a fuller explanation see his note in the comments section.]

Jose Tapia Granados

Jose Tapia Granados

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.”

Comments

  1. William Clarke - 1966

    Admittedly I have not read the original article. However, judging by the foregoing summary, one has to wonder why this study was conducted. What useful information did the author expect to obtain? Catchup will occur any time one cubic-like curve lags another cubic-like curb. In this case at least in the summary we are not told where the southern European countries began relative to the northern European countries. Certainly only an association has been shown, and even any conclusion related to democracy vs. dictatorship is problematic since the southern European countries have been democracies for some three decades. Like in so much of academia there is this overwhelming urge to collect data. This phenomenon is abundantly evident in health related fields. Many of our policymakers are paralyzed if they do not have reems of data at their disposal, never mind that their data is worthless. Just so they have “evidence”. We need to be more discriminating as to where we put our scarce research dollars.

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  2. Chris Slupek - 2006

    U of M is just too liberal in everything they do. I wish this faculty member would have to experience (have lived in) a dictatorship form of government. Then he may have slanted his study results away from the titled (Health is better under right-wing dictatorships) conclusion.
    U of M continues to ignore the reality of the liberal (socialist) vs. the conservative (capitalist) view. Without capitalism, there would be no U of M to attend and perform these frivolous academic studies.

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  3. Chris Landau - 2006

    It sounds like the only place to go was up for the Southern European Countries. This sounds like highly curated data. Not such a hot study. sorry.

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  4. John White - 2013

    Let me get this straight. The Nordic countries have far more advanced levels of health in the 50s and 60s when the southern countries are in the heyday of their right-wing regimes. Then, it takes them a half century to catch up, and that only happens as the transform into more liberalized states. So somehow that proves that health is better in authoritarian regimes? That’s the most illogical conclusion one could draw from those premises. Also, there is way to many other factors, one important being the harsher and testing northern climate. The study also seems to operate under the illusion that these regimes, with almost no transparency, reported their data honestly and correctly. It seems Mr. Tapia Granados has a clear agenda and is try to squeeze some small semblance of Mediterranean pride from some of the worst regimes in recent history with his misguided revisionism. Needless to say, if this article is an accurate representation, I’m embarrassed and dismayed that some of tuition dollars are pooled to fund this tomfoolery.

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  5. Leigh Goldstein - 2001

    This study apparently ignores any differences in climate, seasonal day-light, diet and cultural activities. I\’m fairly confident I\’d live longer in Spain than in Norway.

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  6. Lisa L - 1991

    The article concludes with a warning \’against simplistic or partisan explanations that attribute causality to particular political regimes or parties in power\’, yet the author titles it \’Health is better under right-wing dictatorships, not social democracies\’?
    I understand sensational titles are used to get people to read articles, but must it be actually contrary to the article\\\’s content?

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  7. Miriam Meisler

    Your headline is misleading. There is no indication in the study that “health” is better in the three southern european countries. Rather,during the period 1950-2000, longevity in the southern countries caught up with the higher level achieved earlier in the northern countries.

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  8. H M - 2004

    I too have not read the original piece. That said, the title of this article is completely misleading since the study apparently comes to no conclusion on the subject. The study seems like an observation but the title here implies it’s some sort of controlled scientific study. It leaves me wondering what is the point of this article?

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  9. Patrick Cardiff - 1990

    I haven’t read this either because I’m not interested in politics, but I can comment on the design. Immediately I asked myself: did he control for the effects of WWII.
    Unlike Mr. Clarke above I do not need to expect useful information before I do a research study!
    Mr. Slupek: you are reactionary. How could one professor’s paper represent the University of Michigan in general.
    You people need to forget about politics for a while and consider other sides of the issue. Isn’t that what University is all about?
    Mr. Granados’ probably makes the mistake of mismeasurement from an improper design. Consider comparing one variable in state A with state B. That’s one case! N=1! For good reason, a statistician needs at least N=30 (arbitrary, I agree) to form a distribution, watch the data sit down on a value, and measure the variance, in order to establish significance (let alone robustness). When it comes to social science empiricism, you might require exponentially more evidence than that.
    C’Mon, stop taking his initial findings so seriously! I would say the definitions need standardizing, his indexes and scores need refining, and more tests need to be done.
    I am against studies that have to reject the null to get published – that’s why so many papers find for positive – maybe this is where academia is at fault.
    But Politics is messy, let’s face it – there are just too many more opportunities for bias under subjecive constraints. To put it succinctly, numbers are easier to revise than text!
    Even for apolitical types, I learned to stay away from fuzzy opinions when I taught four years in Tanzania in the 80s – a “socialist” state in word and deed maybe, but a striving democracy nonetheless.
    I would like to believe government protection beats greed, but I don’t see it from his design.

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  10. bernie goitein - 1982

    Are the researcher and the summary writer not aware that Franco and Salazar’s fascist regimes in Spain and Portugal ended in the middle of the 1950-2000 period? That Greece returned to democracy and tossed out the military?
    If you wanted to argue cauality, the results are more consistent with the reverse of the headlline- as John White comments about the former dictatorships: “Then, it takes them a half century to catch up, and that only happens as the transform into more liberalized states.”

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  11. Mary Baker - 1994

    In addition to almost all above,
    is it not true that “health” and “longevity” are two different things?

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  12. john balog - 1958 and 1962

    It is not the type of government or health care. Health is more related to the type of food program (like diet) physical activity.

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  13. David Richards - 1968

    The others are correct that the conclusions of the study, at least as reported in this summary and its headline, seem to be 180 degrees contrary to the facts, as the increase in longevity occurred during periods of liberalization. Perhaps it would have been useful to provide a citation to the study, especially since the periodical in which the study was supposed to have been published does not readily provide access to the article (I could not find it on their website).

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  14. Professor Jose Tapia Granados

    Some friends of mine are wondering if I became a fascist, and they are asking me if I actually said that “health is better under right-wing dictatorships, not social democracies.”
    In the press release I approved the original title was “Are social democracies better for health than right-wing dictatorships?: U-M study” and the first paragraph stated that “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.” Now in the original Michigan Today note the title is “Health is better under right-wing dictatorships, not social democracies,” something that is quite misleading. Indeed, if that were true, then health in Papa Doc’s Haiti, Muhammad Zia-ul-Haq’s Pakistan, or Stroesner’s Paraguay would have been better than in Olof Palme’s Sweden. Of course, I did not say anything like that.

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  15. Angeline johnson - 1996

    As a nordic-American who has sojourned the Nordic countries, I am completely bemused by what was offered here, to we alumni.
    Please, what *department* IS the author in, in the first place?
    Noted is the effects of WWII. Not at all noted was the great industrialization of previously agrarian parts of the Nordics, like in my forebear’s experience. We all know that with industrialization comes erosion of family/community ties, increased urbanization, increased negative behaviors of those so isolated.
    Finnish cinema has a famous film ‘the last wedding’ — the wedding known to be the last one to be held in a village in mid-to-northern finland, where all the other young people had emigrated to find work in more-prosperous Sweden.
    Besides the late urbanization industrialization of the (both!) WWII-impacted and agrarian Finland and Norway, all the nordic countries have had refugees/immigrees, and their health is generally impacted by what can be a pretty strikingly stark adjustment period.
    It is well understood and commented on that alcoholism and suicide rates in the far north of europe are marked. That the ‘urbanized’ diet is having such a deleterious affect on the population, as is the changes of behavior from being 3-4 generations away from subsistence farming, is also not noted, here.
    I have seen the log cabin my grandmother grew up in, wood-heated, housing a family of approximately 8, and obviously lit by oil lamps. I know my cousins in Finland have radically different lives than what our mutual relatives had on her departure.
    How types of governments might intersect with these much larger forces are not clear to me: more useful would be comparing former soviet states of the Baltics and NW Russia to the Nordics, certainly.

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  16. David Howe - 1964;1965

    And so the real question is, “So what?” It is already intuitively obvious that differences in longevity have many causes. Apparently we now know that the type of government under which we live is not one of them. Or maybe it is.

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