Assessing normative claims about democracy and public health: A multi-part approach utilizing quantitative analysis of international datasets with qualitative analyses of South Korea and Singapore as case studies
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Normative understandings of democracy and public health have led to hypotheses that the democratic-ness of a country should be positively associated with its public health outcomes, given that the a democratic state is more likely to be responsive to the needs and demands of its population than an authoritarian regime. However, initial analysis using data from the World Bank and the Freedom House seem to indicate that there is little or no relationship between democracy and public health, and that in some cases, such as Singapore, authoritarian states fare better than democratic states, such as South Korea. I argue that this seeming discrepancy between normative expectations and outcomes can be explained by the following: 1) rather than regime type, democratic experience, or exposure to democratic experiences are positively correlated with better public health outcomes, such that the recent “waves of democratization” in countries without substantial state capacity and extensive democratic experiences has skewed the data; 2) in the short-term, rather than regime type, economic capacity and development are far better predictors of public health outcomes, and 3) in a comparative case study between South Korea and Singapore, South Korea’s seemingly negative performance can be attributed to political transition effects and the impact of liberalism (or illiberalism) on how policy is implemented, rather than the democratic nature of the South Korean government after 1987.