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1.
Int J Environ Res Public Health ; 19(11)2022 05 26.
Article in English | MEDLINE | ID: covidwho-1892855

ABSTRACT

Hong Kong has experienced social unrest in response to the proposed anti-extradition bill since early June 2019. Demonstrations and rallies have often ended in violent clashes between protestors and the police. Based on a sample of 1024 Hong Kong adults, this study explored the psychosocial factors underlying public perceptions of police procedural and distributive justice among Hong Kongers. Testing the propositions of several criminological theories (i.e., neutralization theory, the general aggression model, general strain theory, and self-control theory), the findings indicated that men reported significantly more positive general perceptions of police procedural and distributive justice, better general mental health, and more negative attitudes toward violence than women did. Young adults perceived significantly higher levels of police general, procedural, and distributive justice than did their middle-aged and older counterparts, who reported significantly better general mental health and greater self-control. Multivariate analyses indicated that across all age groups, better general mental health, greater self-control, and more negative attitudes toward violence were significantly associated with positive perceptions of police general, procedural, and distributive justice. This study concludes with practical guidance for enhancing public perceptions of police procedural and distributive fairness.


Subject(s)
Police , Social Justice , Aged , Democracy , Female , Hong Kong , Humans , Male , Middle Aged , Social Justice/psychology , Trust , Young Adult
3.
Disasters ; 45 Suppl 1: S26-S47, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1555603

ABSTRACT

The Covid-19 crises in the United Kingdom and the United States show how democracies may struggle to confront disasters that are increasingly impinging on the Global North. This paper highlights the extent to which disasters are now 'coming home' to Western democracies and it looks at some of the principal reasons why democracy has not been especially protective, at least in the case of the UK and the US. These include: reconceptualising disaster as a good thing (via 'herd immunity'); the influence of neoliberalism; and the limitations in the circulation of information. A key pandemic-related danger is the conclusion that democracy itself is discredited. Disasters, though, call for a reinvigoration of democracy, not a knee-jerk invocation of autocratic 'emergency' rule. A fundamental problem in the UK and US is that these countries were not democratic enough. The paper underlines the risk of a move towards a disaster-producing system that is self-reinforcing rather than self-correcting.


Subject(s)
COVID-19 , Democracy , Humans , Politics , SARS-CoV-2 , United Kingdom , United States
4.
PLoS One ; 16(12): e0259473, 2021.
Article in English | MEDLINE | ID: covidwho-1546939

ABSTRACT

The present study, conducted immediately after the 2020 presidential election in the United States, examined whether Democrats' and Republicans' polarized assessments of election legitimacy increased over time. In a naturalistic survey experiment, people (N = 1,236) were randomly surveyed either during the week following Election Day, with votes cast but the outcome unknown, or during the following week, after President Joseph Biden was widely declared the winner. The design unconfounded the election outcome announcement from the vote itself, allowing more precise testing of predictions derived from cognitive dissonance theory. As predicted, perceived election legitimacy increased among Democrats, from the first to the second week following Election Day, as their expected Biden win was confirmed, whereas perceived election legitimacy decreased among Republicans as their expected President Trump win was disconfirmed. From the first to the second week following Election Day, Republicans reported stronger negative emotions and weaker positive emotions while Democrats reported stronger positive emotions and weaker negative emotions. The polarized perceptions of election legitimacy were correlated with the tendencies to trust and consume polarized media. Consumption of Fox News was associated with lowered perceptions of election legitimacy over time whereas consumption of other outlets was associated with higher perceptions of election legitimacy over time. Discussion centers on the role of the media in the experience of cognitive dissonance and the implications of polarized perceptions of election legitimacy for psychology, political science, and the future of democratic society.


Subject(s)
Emotions , Mass Media/statistics & numerical data , Motivation , Politics , Cognitive Dissonance , Democracy , Humans , Mass Media/ethics , United States
5.
Nat Hum Behav ; 5(12): 1608-1621, 2021 12.
Article in English | MEDLINE | ID: covidwho-1526082

ABSTRACT

Developed democracies proliferated over the past two centuries during an unprecedented era of economic growth, which may be ending. Macroeconomic forecasts predict slowing growth throughout the twenty-first century for structural reasons such as ageing populations, shifts from goods to services, slowing innovation, and debt. Long-run effects of COVID-19 and climate change could further slow growth. Some sustainability scientists assert that slower growth, stagnation or de-growth is an environmental imperative, especially in developed countries. Whether slow growth is inevitable or planned, we argue that developed democracies should prepare for additional fiscal and social stress, some of which is already apparent. We call for a 'guided civic revival', including government and civic efforts aimed at reducing inequality, socially integrating diverse populations and building shared identities, increasing economic opportunity for youth, improving return on investment in taxation and public spending, strengthening formal democratic institutions and investing to improve non-economic drivers of subjective well-being.


Subject(s)
COVID-19 , Climate Change , Democracy , Developed Countries , Economics , Sociological Factors , Economic Development/trends , Humans
7.
Am J Health Syst Pharm ; 78(21): 1938-1939, 2021 10 25.
Article in English | MEDLINE | ID: covidwho-1493671
8.
PLoS One ; 16(10): e0257757, 2021.
Article in English | MEDLINE | ID: covidwho-1450728

ABSTRACT

CONTEXT: The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting points, as understanding of the relative impact of structural aspects should facilitate achieving optimal forward progress. METHODS: Desk study, based on selecting and collecting a range of measures for 48 representative characteristics of 42 countries' demography, society, health system, and policy-making profiles, matched to three pandemic time points. Different analytic approaches were employed including correlation, multiple regression, and cluster analysis in order to seek triangulation. FINDINGS: Population structure (except country size), and volume and nature of health resources, had only minor links to Covid impact. Depth of social inequality, poverty, population age structure, and strength of preventive health measures unexpectedly had no moderating effect. Strongest measured influences were population current enrolment in tertiary education, and country leaders' strength of seeking scientific evidence. The representativeness, and by interpretation the empathy, of government leadership also had positive effects. CONCLUSION: Strength of therapeutic health system, and indeed of preventive health services, surprisingly had little correlation with impact of the pandemic in the first nine months measured in death- or case-rates. However, specific political system features, including proportional representation electoral systems, and absence of a strong single party majority, were consistent features of the most successful national responses, as was being of a small or moderate population size, and with tertiary education facilitated. It can be interpreted that the way a country was lead, and whether leadership sought evidence and shared the reasoning behind resultant policies, had notable effects. This has significant implications within health system development and in promoting the population's health.


Subject(s)
COVID-19/pathology , Democracy , COVID-19/epidemiology , COVID-19/mortality , COVID-19/virology , Emergency Medical Services , Health Policy , Humans , Pandemics , Public Health , Resilience, Psychological , SARS-CoV-2/isolation & purification , Socioeconomic Factors
9.
PLoS One ; 16(9): e0257557, 2021.
Article in English | MEDLINE | ID: covidwho-1430540

ABSTRACT

OBJECTIVES: Empathy is fundamental to social cognition, driving prosocial behaviour and mental health but associations with aging and other socio-demographic characteristics are unclear. We therefore aimed to characterise associations of these characteristics with two main self-reported components of empathy, namely empathic-concern (feeling compassion) and perspective-taking (understanding others' perspective). METHODS: We asked participants in an internet-based survey of UK-dwelling adults aged ≥18 years to complete the Interpersonal Reactivity Index subscales measuring empathic concern and perspective taking, and sociodemographic and personality questionnaires. We weighted the sample to be UK population representative and employed multivariable weighted linear regression models. RESULTS: In 30,033 respondents, mean empathic concern score was 3.86 (95% confidence interval 3.85, 3.88) and perspective taking was 3.57 (3.56. 3.59); the correlation between these sub-scores was 0.45 (p < 0.001). Empathic concern and perspective taking followed an inverse-u shape trajectory in women with peak between 40 and 50 years whereas in men, perspective taking declines with age but empathic concern increases. In fully adjusted models, greater empathic concern was associated with female gender, non-white ethnicity, having more education, working in health, social-care, or childcare professions, and having higher neuroticism, extroversion, openness to experience and agreeableness traits. Perspective taking was associated with younger age, female gender, more education, employment in health or social-care, neuroticism, openness, and agreeableness. CONCLUSIONS: Empathic compassion and understanding are distinct dimensions of empathy with differential demographic associations. Perspective taking may decline due to cognitive inflexibility with older age whereas empathic concern increases in older men suggesting it is socially-driven.


Subject(s)
Empathy , Socioeconomic Factors , Adolescent , Adult , Age Factors , Aged , Cross-Sectional Studies , Democracy , Educational Status , Female , Humans , Internet , Male , Middle Aged , Personality , Surveys and Questionnaires , United Kingdom
11.
Environ Sci Pollut Res Int ; 29(6): 8694-8704, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1397041

ABSTRACT

Many studies have evaluated factors that influence the course of the COVID-19 pandemic in different countries. This multicountry study assessed the influence of democracy and other factors on the case fatality rate of COVID-19 during the early stage of the pandemic. We accessed the World Health Organization, World Bank, and the Democracy Index 2019 databases for data from the 148 countries. Multiple analyses were conducted to examine the association between the Democracy Index and case fatality rate of COVID-19. Within 148 countries, the percentage of the population aged 65 years and above (p = 0.0193), and health expenditure as a percentage of GDP (p = 0.0237) were positively associated with countries' case fatality rates. By contrast, hospital beds per capita helped to reduce the case fatality rates. In particular, the Democracy Index was positively associated with case fatality rates in a subgroup of 47 high-income countries. This study suggests that enhancing the health system with increased hospital beds and healthcare workforce per capita should reduce case fatality rate. The findings suggest that a higher Democracy Index is associated with more deaths from COVID-19 at the early stage of the pandemic, possibly due to the decreased ability of the government.


Subject(s)
COVID-19 , Pandemics , Democracy , Humans , SARS-CoV-2 , World Health Organization
13.
Health Aff (Millwood) ; 40(8): 1234-1242, 2021 08.
Article in English | MEDLINE | ID: covidwho-1337574

ABSTRACT

Despite widespread recognition that universal health coverage is a political choice, the roles that a country's political system plays in ensuring essential health services and minimizing financial risk remain poorly understood. Identifying the political determinants of universal health coverage is important for continued progress, and understanding the roles of political systems is particularly valuable in a global economic recession, which tests the continued commitment of nations to protecting their health of its citizens and to shielding them from financial risk. We measured the associations that democracy has with universal health coverage and government health spending in 170 countries during the period 1990-2019. We assessed how economic recessions affect those associations (using synthetic control methods) and the mechanisms connecting democracy with government health spending and universal health coverage (using machine learning methods). Our results show that democracy is positively associated with universal health coverage and government health spending and that this association is greatest for low-income countries. Free and fair elections were the mechanism primarily responsible for those positive associations. Democracies are more likely than autocracies to maintain universal health coverage, even amid economic recessions, when access to affordable, effective health services matters most.


Subject(s)
Economic Recession , Universal Health Insurance , Democracy , Health Expenditures , Health Services , Humans , Political Systems
14.
Front Public Health ; 9: 678210, 2021.
Article in English | MEDLINE | ID: covidwho-1323098

ABSTRACT

The COVID-19 pandemic ("the pandemic") has magnified the critical importance of public policy deliberation in public health emergency circumstances when normal health care operations are disrupted, and crisis conditions prevail. Adopting the lens of syndemic theory, the disproportionate impact of the pandemic on vulnerable older adults suggests that the pandemic has heightened pre-existing precarities and racial inequities across diverse older adult populations, underlining the urgency of needed policy reforms. While the pandemic has called attention to systemic failures in U.S. public health emergency planning at both federal and state levels of government, the important role of civil society in influencing policy decision making and advocating for legal and ethics reforms and social change in a democracy calls for more open dialogue in aging, public health and legal communities and constituencies. To foster this dialogue, one public health lawyer, who is also a bioethicist and gerontological social work researcher and served as chair of the New York State Bar Association Health Law Section COVID Task Force in 2020 ("Task Force"), shares her first-person perspectives on the process of leading the development of a statewide bar's recommendations for policy reforms, including the challenges and conflicts encountered. A hospital-based attorney and clinical bioethicist brings a clinical ethics perspective to the discussions. This first-person contribution discusses the power of constituencies to influence policy deliberation in a democracy, and the implications of the Task Force recommendations for future aging and public health policy, particularly in view of the high suffering burdens and trauma older persons and older people of color have borne during the pandemic.


Subject(s)
COVID-19 , Pandemics , Aged , Aged, 80 and over , Democracy , Humans , New York , Pandemics/prevention & control , Policy , SARS-CoV-2
17.
PLoS One ; 16(6): e0253485, 2021.
Article in English | MEDLINE | ID: covidwho-1280633

ABSTRACT

How does a public health crisis like a global pandemic affect political opinions in fragile democratic contexts? Research in political science suggests several possible public reactions to crisis, from retrospective anti-incumbency to rally 'round the flag effects to democratic erosion and authoritarianism. Which of these obtains depends on the nature of the crisis. We examine whether and how the onset of the global pandemic shifted public opinion toward the president, elections, and democracy in Haiti. We embedded two experiments in a phone survey administered to a nationally representative sample of Haitians in April-June 2020. We find that the early pandemic boosted presidential approval and intentions to vote for the incumbent president, consistent with a rally effect. These results show that a rally effect occurs even in the most unlikely of places-an unstable context in which the incumbent president is struggling to maintain order and support. At the same time, we find scant evidence that the onset of the pandemic eroded democratic attitudes, even in a context in which democracy rests on uncertain grounds.


Subject(s)
COVID-19/epidemiology , Democracy , Health Knowledge, Attitudes, Practice , Pandemics , COVID-19/virology , Disasters , Politics , SARS-CoV-2/physiology
18.
Hist Philos Life Sci ; 43(2): 66, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1210756

ABSTRACT

The COVID-19 pandemic poses extraordinary public health challenges. In order to respond to such challenges, most democracies have relied on so-called 'evidence-based' policies, which supposedly devolve to science the burden of their justification. However, the biomedical sciences can only provide a theory-laden evidential basis, while reliable statistical data for policy support is often scarce. Therefore, scientific evidence alone cannot legitimise COVID-19 public health policies, which are ultimately based on political decisions. Given this inevitable input on policy-making, the risk of arbitrariness is ubiquitous and democratic scrutiny becomes essential to counter it. During the COVID-19 pandemic, the standards of scientific and democratic scrutiny have been, as a matter of fact, substantially lowered. This erosion potentially damages democracy.


Subject(s)
COVID-19/epidemiology , Evidence-Based Practice , Health Policy , Policy Making , COVID-19/prevention & control , Democracy , Evidence-Based Practice/standards , Government , Humans
19.
Scand J Public Health ; 49(1): 104-113, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1207571

ABSTRACT

AIMS: The COVID-19 pandemic has led to a spate of studies showing a close connection between inequitable access to health care, welfare services and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question by asking whether more 'egalitarian' forms of democracy matter, given that they contain more equitable health-care access and societal infrastructure, such as social capital and trust. METHODS: We use standard regression techniques, including instrumental variables analysis addressing endogeneity on COVID-19 testing and deaths data as of the end of May and beginning of September. We use novel data from the Varieties of Democracy Project on health-system equity and egalitarian democracy. RESULTS: Our results suggest that more equitable access to health care increases testing rates and lowers the death rate from COVID-19. Broader egalitarian governance, measured as egalitarian democracy, however, shows the opposite effect. Thus, factors associated with health-care capacity to reach and treat matter more than broader societal factors associated with social capital and trust. The results are robust to alternative testing procedures, including instrumental variable technique for addressing potential endogeneity. CONCLUSIONS: Despite a great deal of public health focus on how equitable governance helps fight the adverse effects of so-called neoliberal pandemics, we find that broadly egalitarian factors have had the opposite effect on fighting COVID-19, especially when an equitable health system has been taken into account. Fighting disease, thus, might be more about the capacity of health systems rather than societal factors, such as trust in government and social capital.


Subject(s)
COVID-19/therapy , Delivery of Health Care/organization & administration , Democracy , Health Equity , COVID-19/epidemiology , Empirical Research , Humans , Treatment Outcome , United States/epidemiology
20.
Rev Infirm ; 70(270): 1, 2021 04.
Article in French | MEDLINE | ID: covidwho-1164383
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