For Better Welfare Outcomes, Help Dual Income Households And Basic Pensions

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Main Category: Public Health
Also Included In: Pediatrics / Children's Health;  Seniors / Aging
Article Date: 15 Nov 2008 - 0:00 PST

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When policies are implemented to provide support for families with both parents earning income, infant mortality is decreased, in comparison with initiatives that provide support for traditional male-earning and female-home workers, which do not, according to an article released on November 7, 2008 in The Lancet.

The Organisation for Economic Co-operation and Development (OECD) consists of several countries which are committed to democracy and the market economy from around the world. These countries are widely varied in their economic development and social characteristics. Welfare support is employed in all high-income nations, with varying success, and their variety in design and generosity is reflected in a wide range of poverty rates, which affect children and elderly people in particular.

To investigate the effects of various health care policies on lives in different countries, Professor Olle Lundberg, Stockholm University/Karolinska Institutet, Sweden, and colleagues analyzed the infant mortality rates and old-age excess mortality rates as they compare over various social policy characteristics and levels of generosity. in 18 OECD countries between 1970 and 2000 (for family policies) and between 1950 and 2000 (for pension policies.)

In analyzing the results, the authors found that by increasing generosity towards dual-earner familes, a lower infant mortality rate was also found. In contrast, generosity in policies that supported more traditional families with employed men and home-working women does not decrease the infant mortality rate. In quantitative terms, increasing dual-earning support by 1% was associated with a decrease in infant mortality by 0.04 per 1000 births.

In generosity towards security pensions, additional action in the basic type of pensions was linked to decreased old-age excess mortality, while earning-related income security pensions were not. In quantitative terms, increasing basic security pensions by one percentage point was associated with a decrease in old-age excess mortality of 0.02 per 1000 men or women. 

In conclusion, the authors note the importance of this sort of investigation: "The ways in which social policies are designed, as well as their generosity, are important for health because of the increase in resources that social policies entail. Hence, social policies are of major importance for how we can tackle the social determinants of health."

Dr Steinar Westin, Norwegian University of Science and Technology, Norway, contributed an accompanying comment in which he notes some of the drawbacks of the unsuccessful programs: "Targeting of 'the truly needy' may seem economically attractive, but implies stigmatisation and 'more tests of the poor'. Furthermore, economic research shows that universal welfare programmes might be more effective in achieving sustained alleviation of poverty because such programmes are more likely to retain political support among voters

The role of welfare state principles and generosity in social policy programmes for public health: an international comparative study
Olle Lundberg, Monica Åberg Yngwe, Maria Kölegård Stjärne, Jon Ivar Elstad, Tommy Ferrarini, Olli Kangas, Thor Norström, Joakim Palme, Johan Fritzell, for the NEWS Nordic Expert Group
Lancet 2008; 372: 1633-40
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Written by Anna Sophia McKenney
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