Health inequalities and welfare state regimes: a research note

Abstract

Aim: Comparative research on health and health inequalities has recently begun implementing a welfare regime perspective. The aim of the study was to review the existing evidence for identifying the determinants of health and health inequalities in highly developed welfare states and to develop a theoretical model for future research approaches. Subject: A welfare state regime typology is applied to comparatively analyse (1) the relationship between the level of economic prosperity in a society and its respective level of overall population health and (2) the nature of the corresponding relationship between economic inequalities and health inequalities in different groups of countries. Results: Although the Social Democratic welfare states have a relatively equal distribution of material wealth as well as the highest levels of population health, they are not characterised by the smallest levels of health inequality. Rather, with respect to health equality, conservative countries seem to perform better than social democracies. We propose a comprehensive theoretical model that takes into account different factors on the structural (macro), organisational (meso) and individual (micro) level in order to contribute to a better understanding of this important challenge for public health policy and practice. Conclusion: Future research will require an appropriate theoretical model with the potential to explain health and health inequalities in different types of welfare states. On the basis of this model, future research should test the hypothesis that in highly developed countries not only economic, but also social, cultural and lifestyle factors are important in determining health outcomes in different segments of the population.