National health policies and population health outcomes in 17 OECD countries: an application of the welfare state regimes concept

Abstract

This project examines the extent to which industrialized countries’ national social policy orientations (welfare state regimes), which shape social cohesion and inequality, reflect the structure of their healthcare policies and/or population health characteristics. Hierarchical cluster analysis is used with data from 17 OECD countries in order to assess inductively the extent to which established welfare state regime groupings emerge when a wide range of population health and health policy measures are analyzed. Overall findings are that welfare state regime typologies are evident when child health measures are used, but not when other measures of population health (adult health measures, chronic and infectious diseases) or health policy measures are applied. This has implications for emerging work within the population health field that has used child health measures to argue that welfare state regime orientations have direct impacts on population health in general. Results also question the extensive reliance on infant mortality rates as a summary of national population health. Finally, results cast doubt on the assumption that welfare state regime types share parallel healthcare policy structures and orientations. Rather, it appears that different historical, political and popular pressures, which result from specific historical events, have driven policy areas in different directions within national welfare states. A more detailed model of population health, welfare states and health-specific policies is developed to guide future research.