Välfärdsregimer och hälsa - en litteraturstudie om determinanter på makronivå
VälfärdsregimHälsoindikatorVälfärdsstatsvariabelJämförelseWelfare regimeHealth indicatorWelfare state determinantComparison
Introduction: Public health researchers have long been focusing on investigating health inpopulations through determinants such as income inequalities. Nevertheless, incomeinequalities can be considered an effect of the organization of welfare regimes. The publichealth status is largely affected by the organization of welfare regimes and consequently thereare large differences in health within and between welfare regimes. How are these differencesdistributed and how can they be explained?Aim: To compare health between welfare state regimes with the use of Esping-Andersen?swelfare regime typology and to investigate the relationship between welfare statedeterminants and health.Methods: A literary review based on 12 scientific articles. The articles were searched for inthe databases PubMed and Scopus. The analysis of the articles was executed through textanalysis and the identification of relationships between welfare regimes, health indicators andwelfare state determinants.Results: Differences in absolute level of health and health inequalities existed betweenwelfare state regimes. Rates of infant mortality, under five mortality and low birth weightwere in general highest in the liberal regime, second highest in the conservative regime andlowest in the social democratic regime. Self-reported health inequalities were largest in theliberal regime when low- and high-income earners were compared and largest in the socialdemocratic regime when low- and highly educated were compared. The welfare statevariables public health expenditure and share of population under public medical care showedassociations with rates of infant mortality, under five mortality and low birth weight.Discussion: Possible solutions to differences in absolute level of health and health inequalitiesbetween welfare state regimes was found in the underlying ideologies of each regime. Thefact that the amount of public health expenditures and the share of population that is underpublic medical care varied between welfare state regimes should be contributing factors to thedemonstrated health differences.