Dataset Information

Health-system equity, egalitarian democracy and COVID-19 outcomes: An empirical analysis.

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.

SUBMITTER: Vadlamannati KC

PROVIDER: S-EPMC7797351 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Health-system equity, egalitarian democracy and COVID-19 outcomes: An empirical analysis.

Vadlamannati Krishna Chaitanya KC Cooray Arusha A de Soysa Indra I

Scandinavian journal of public health 20210109 1

<h4>Aims</h4>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 cont ...[more]

PMID: 33427079

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Project description:This paper aims to understand the impact of COVID-19 on three mental health outcomes-anxiety, depression, and mental health service use. Specifically, whether the associations between social and economic variables and these outcomes are exacerbated or buffered among equity-seeking groups in Saskatchewan. We analyzed secondary datasets of Saskatchewan adults from population-based national surveys conducted by Mental Health Research Canada (MHRC) on three occasions: cycle 2 (August 2020), cycle 5 (February 2021), and cycle 7 (June 2021). We examined temporal changes in the prevalence of anxiety, depression, and service utilization. Using the responses from 577 respondents in cycle 5 dataset (as it coincides with the peak of 2nd wave), we performed multinomial logistic regression. The policy implications of the findings were explored empirically through a World Café approach with 30 service providers, service users and policy makers in the province. The prevalence of anxiety and depression remained steady but high. Mental health services were not accessed by many who need it. Participants reporting moderate or severe anxiety were more likely to be 30-49 years old, women, and immigrants who earned less than $20,000 annually. Immigrants with either college or technical education presented with a lesser risk of severe anxiety. Factors associated with moderate or severe depression were younger age (<50 years), low household income, as well as immigrants with lower levels of education. Racialized groups had a lower risk of severe depression if they were under 30 years. Students and retirees also had a lower risk of severe depression. Canadian-born residents were more likely to require mental health supports but were not accessing them, compared to immigrants. Our analysis suggests mental health outcomes and service utilization remain a problem in Saskatchewan, especially among equity-seeking groups. This study should help drive mental health service redesign towards a client-centred, integrated, and equity-driven system in Saskatchewan.

Dataset Information

Health-system equity, egalitarian democracy and COVID-19 outcomes: An empirical analysis.

Aims

Methods

Results

Conclusions

Publications

Health-system equity, egalitarian democracy and COVID-19 outcomes: An empirical analysis.

Similar Datasets

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