Political economy and population health: is Australia exceptional?

Anne-marie Boxall, Stephanie D Short
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Abstract

Background: It is accepted knowledge that social and economic conditions--like education and income--affect population health. What remains uncertain is whether the degree of inequality in these conditions influences population health and if so, how. Some researchers who argue that inequalities are important, say there is a relationship between political economy, inequality and population health. Their evidence comes from comparative studies showing that countries with neo-liberal political economies generally have poorer population health outcomes than those with social or Christian democratic political economies. According to these researchers, neo-liberal political economies adopt labour market and welfare state policies that lead to greater levels of inequality and poorer population health outcomes for us all.

Discussion: Australia has experienced considerable social and economic reforms over the last 20 years, with both major political parties increasingly adopting neo-liberal policies. Despite these reforms, population health outcomes are amongst the best in the world.

Summary: Australia appears to contest theories suggesting a link between political economy and population health. To progress our understanding, researchers need to concentrate on policy areas outside health--such as welfare, economics and industrial relations. We need to do longitudinal studies on how reforms in these areas affect levels of social and economic inequality, as well population health. We need to draw on social scientific methods, especially concerning case selection, to advance our understanding of casual relationships in policy studies. It is important to find out if, and why, Australia has resisted the affects of neo-liberalism on population health so we ensure our high standards are maintained in the future.

政治经济与人口健康:澳大利亚是例外吗?
背景:社会和经济条件--如教育和收入--会影响人口健康,这已成为共识。但仍不确定的是,这些条件的不平等程度是否会影响人口健康,如果会,又是如何影响的。一些认为不平等现象很重要的研究人员说,政治经济、不平等和人口健康之间存在关系。他们的证据来自比较研究,研究表明,与社会或基督教民主政治经济国家相比,新自由主义政治经济国家的人口健康状况普遍较差。根据这些研究人员的观点,新自由主义政治经济体所采取的劳动力市场和福利国家政策导致了更大程度的不平等,并给我们所有人带来了更差的人口健康结果:澳大利亚在过去 20 年中经历了相当大的社会和经济改革,两个主要政党都越来越多地采取新自由主义政策。尽管进行了这些改革,澳大利亚的人口健康状况在世界上却名列前茅。总结:澳大利亚似乎对政治经济与人口健康之间存在联系的理论提出了质疑。为了加深我们的理解,研究人员需要专注于健康以外的政策领域,如福利、经济和劳资关系。我们需要对这些领域的改革如何影响社会和经济不平等程度以及人口健康进行纵向研究。我们需要借鉴社会科学方法,特别是有关案例选择的方法,以促进我们对政策研究中偶然关系的理解。重要的是,我们要弄清澳大利亚是否以及为何抵制了新自由主义对人口健康的影响,从而确保我们的高标准在未来得以保持。
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