Is Redistribution Good for Our Health? Examining the Macro-Correlation between Welfare Generosity and Health across EU Nations over the Last 40 Years.

CONTEXT: Social determinants of health are finally getting much needed policy attention. Yet, their political origins remain underexplored. In this paper, we advance a theory of political determinants as accruing along three pathways of welfare state effects (redistribution, poverty reduction and status preservation) and test these assumptions by examining impacts of policy generosity on life expectancy (LE) over the last 40 years. METHODS: We merge new and existing welfare policy generosity data from the Comparative Welfare Entitlement Project (CWEP) with data on LE spanning 1980-2018 across 21 OECD countries. We then examine relationships between five welfare policy generosity measures and LE using cross-sectional differencing and auto-regressive lag models. FINDINGS: We find consistent and positive effects for total generosity (an existing measure of social insurance generosity) on LE at birth across different model specifications in the magnitude of a 0.10-0.15-year increase in LE at birth (p < 0.05) and a measure of status preservation (0.11, p < 0.05). We find less consistent support for our redistribution and poverty reduction measures. CONCLUSIONS: We conclude that in addition to generalized effects of policy generosity on health, status-preserving social insurance may be an important, and relatively overlooked, mechanism in increasing life expectancies over time in advanced democracies.