Democracy Linked to Improved Health Outcomes, Research Shows

What is Democracy?

Democracy is a system of government where the people are in charge. They elect representatives to make decisions on their behalf. It is based on the principles of equality, freedom, and justice.

Research shows that there is a link between democracy and health. Countries with higher levels of democracy have lower rates of infant mortality, maternal mortality, and higher life expectancy. There are several possible explanations for this.

The research is conclusive; people who live in democracies tend to be healthier than people who don’t.

The US has a representative democracy. There are many different types of democracies, each with its own characteristics. All democracies share basic principles, such as:

• Political equality: All citizens have the right to participate in the political process.
• Popular Sovereignty: The people have the power.
• Majority rule: Decisions are made by majority vote.
• Minority Rights: The rights of minorities are protected.
• Rule of Law: Everyone is bound by the law.

Democracy and Health: What’s the Connection?

In a 2022 study published in The Lancet, the research found that democratic countries were more likely to have universal health coverage, spend more money on healthcare and invest in large-scale public health initiatives.

Interestingly, democracies that promote public health and preventative care, such as clean air and water, safe food, vaccination campaigns and access to quality healthcare showed higher life expectancy.

Despite the US not having universal healthcare, most states have expanded access to healthcare through the Affordable Care Act of 2010. This made healthcare accessible to millions of people.

Furthermore, democracies are also more likely to have strong social safety nets. Social  safety nets help people cope with financial hardship and other stressors that can negatively impact health.

Additionally, democracies are better at managing conflict and resolving disputes peacefully. This can lead to a more stable and peaceful society that can have a positive impact on health.

Even though there is no guarantee that democracy will always lead to good health outcomes. There are many other factors that can influence health, such as income, education, and access to healthcare.

The research suggests that democracy is an important factor that can contribute to better health for all.

Without Public Health Initiatives, Democracy Is at Risk

Public health programs are some of the most effective ways democratic societies help to improve the health of their citizens. We have evidence in our history that shows us how a lack of public health initiatives can negatively affect the physical and mental health of our citizens.

Let’s nerd out on some US history so you can see how important the relationship between democracy and health really is.

The Spanish Flu of 1918

The Spanish flu was a highly contagious and deadly virus that killed an estimated 50 million people worldwide. In the US, it’s estimated that over 600, 000 citizens died from the Spanish Flu.

The US government’s response to the Spanish flu pandemic was said to be inadequate.

Some argue that the government did not invest in public health measures such as public education campaigns. This resulted in the virus spreading rapidly and causing preventable deaths and suffering.

In comparison to other major cities in developed countries, New York City experienced more death than London or Berlin.

The Great Depression of 1929

The Great Depression was a period of severe economic hardship in the United States that lasted for 10 years. During the Great Depression, the US government cut funding for many public health programs. Unfortunately, this led to a decline in public health, rise in poverty and an increase in disease rates and suicides in the US.

There are more instances in US history where the lack of public health investment led to astronomical decline in the health of Americans. These include:

1. The yellow fever epidemic of 1878 in Memphis, Tennessee. Reports state that over 5,000 deaths occurred.
2. The cholera epidemic of 1832 in New York City was estimated to kill almost 4,000 people.
3. The tuberculosis epidemic of the late 19th and early 20th centuries was estimated to have killed over a million people in the United States.
4. The HIV/AIDS epidemic of the 1980s and 1990s killed over 700,000 people in the United States.

Each health crisis outlined above caused outcry from the public. The consequences of citizens speaking up brought about significant changes to health and social policies. This is democracy at work!

The New Deal Program under the presidency of Roosevelt in 1933 played a key role in promoting health for every American citizen.

Knowledge of how diseases spread led to public health programs such as quarantining, safe water initiatives and much more. This led to the decline in certain diseases such as whooping cough, tuberculosis, just to name a few. However, the reception of these policies at the time was lukewarm.

The Benefits of Public Health & Its Impact on Democracy

Throughout the history of America, you can see that many benefitted from public health policies. Whether government should practice restraint in how to enforce policies are controversial. Nevertheless, there are many benefits to living in a democratic society.

Below are a few public health policies we continue to benefit from today:

• The Pure Food and Drug Act of 1906 was passed in response to public outcry over the sale of unsafe and contaminated food and drugs. The act created the Food and Drug Administration (FDA), which is responsible for ensuring the safety of food and drugs in the United States. The FDA limits the use of additives, pesticides and unsafe prescription drugs. The passage of this act led to a significant decrease in foodborne illness and preventable deaths.

• The Social Security Act of 1935 created a social safety net for many Americans. The act increased Social Security Benefits and ensured Medicare health insurance for the elderly and disabled. The passage of this act led to a significant decrease in poverty, medical debt and improved access to healthcare for millions of Americans.

• The Civil Rights Act of 1964 prohibited discrimination based on race, color, religion, sex, or national origin. This resulted in improved access to healthcare and other resources for African Americans and other minority groups. People can no longer be denied receiving medical care based on their race, color, religion, sex or national origin. This has improved the health outcomes for minority communities and increased access to health care.

• The Occupational Safety and Health Act (OSHA) of 1970 improved working conditions for Americans. It mandates that workers should be protected from hazards in the workplace that cause injury or compromise employees’ health. One example of this is in the healthcare industry. Employers must provide protective personal equipment to front line workers such as gloves, masks and properly ventilated areas, among other things.  The passage of this act led to a significant decrease in workplace injuries and preserved the health of workers.

• The passage of the Affordable Care Act (ACA) of 2010 expanded health insurance coverage to millions of Americans. It made it illegal for insurance companies to deny coverage to people with pre-existing conditions. This act led to a decrease in the number of uninsured Americans and an increase in the number of people who had access to preventive care.

The People’s Democracy

While the public did not vote directly on these policies, they play ed a vital role in influencing their passage.

For example, the Social Security Act of 1935 was passed in response to the Great Depression, which had a devastating impact on the American economy and led to widespread poverty.

Additionally, the Civil Rights Act of 1964 was passed in response to the Civil Rights Movement, to end the racial inequality. There was significant outcry when people of color were denied accessing healthcare, getting a good education, working, and shopping for a home etc.

Research concludes that access to quality healthcare, and social environment plays a role in life expectancy.

The Role of Government in Promoting Health

We have seen that government intervention in promoting health has improved the well-being of many Americans. However, the government’s role in healthcare is complex and often controversial. Some believe that the government should play a more active role in regulating and funding healthcare. On the other hand, some believe that the government should play a more limited role and allow the private sector to take the lead in providing healthcare services.

I believe the government should play a more limited role in healthcare, now that the Affordable Care Act has been passed.

The debate over the government’s role in healthcare is likely to continue for many years to come. However, one thing is clear, the government plays a significant role in regulating and funding healthcare in the United States.

The Affordable Care Act, the Veteran’s Healthcare System, and the Importance of Listening to the People

When we look at all other countries like Great Britain and Germany, the US lags behind in the health of its citizens.

Why is that?

Many would argue that the government is inefficient in running a healthcare system.

The current state of the Veteran’s Healthcare System gives some credibility to this claim. It further gives insights to what universal healthcare in the US could potentially be. Additionally, many patients fear losing the care of their current health providers, among other reasons.

The role of government in healthcare should ensure that qualified citizens have access to healthcare. In addition, it should restrain itself when it comes to mandates.

Democracy at its core describes a system where the people choose representatives that will argue for their cause and their plight. Thus, by extension, the representative has nothing to gain, but must act in good faith to the people he/she represents.

The peoples’ voices must be heard loud and clear.

I have outlined how democracy has been a driving force to bring about tremendous changes in improving the health of millions of Americans. I have faith that the American people are great advocates for themselves. However, we need representatives who will listen and act in our favor.

Limited Government Intervention in Healthcare: Efficiency, Choice, and Cost

My reasons for advocating for limited government intervention are simple:

• Efficiency

We need innovative ways to improve efficiency. We need new ideas on how to make the healthcare system as efficient and effective in promoting better health outcomes for Americans. Many argue that the private sector is more efficient at delivering healthcare services than the government.

I cannot argue against that claim. One of my first jobs was for a city-run health facility. It was one of the worse experiences of my healthcare career. There were health infractions all around such as low inventory of basic supplies to care for my patients, antiquated systems and recurrent staffing issues.

The fact is, private companies have a greater incentive to be efficient and provide high-quality care. They are competing for customers, and without customers, they are out of business.

• Choice

Individuals should have more choice in their healthcare. According to a survey, the average wait time to see a specialist if you have private health insurance is 26 days. Individuals receiving care from most government-run healthcare systems like the Veterans Health System, have longer wait times to receive care and limited access to specialists.

• Cost

Government-run healthcare systems are expensive. Administrative costs account for roughly 30% of healthcare costs in the US. We simply cannot provide free healthcare for everyone with the current high costs of healthcare. In addition, Medicaid and Medicare spending are astronomical. Reports show spending over billions of dollars in 2021. These programs need cost savings measures if the goal is increased health care access.

Democracy and Health: A Free Market Approach to Expanding Choice and Reducing Government Control

• To curtail the role of government in healthcare while creating the best features of a free market, the government can expand eligibility for subsidies to help people purchase health insurance. However, it would not mandate but encourage everyone to have health insurance.
• The government might regulate the healthcare industry to ensure safety and quality, but it would not own or operate hospitals or clinics.
• The government might provide healthcare to the poor and elderly, but it would not pass laws to provide healthcare to everyone.

Defending Democracy and Public Health by Opposing Censorship of Health Information

In the wake of the pandemic, Americans experienced something we have never experienced before. Health Information was censored on the news and on social media regarding the origin of the COVID virus, mitigation efforts, effectiveness of the vaccine and more.

A study by the Pew Research Center found that more than half of Americans agreed that the government handled information about how to contain the COVID-19 virus and protect oneself poorly, even though 73% of Americans are vaccinated.

Still, many believe that the censorship of COVID-related information was justified, some disagree. Opponents argue that government censorship of health information prevents the public from accessing accurate and potentially-life saving information and threatens democracy.

 

How Government Censorship of Health Information Threatens Public Health Initiatives

Undoubtedly, censorship of health information can cause several negative consequences such as:

• Increased Spread of Disease

When people do not have access to accurate information about diseases, they are more likely to spread those diseases to others. For example, if people are not aware of the dangers of smoking, they are more likely to smoke. Additionally, they will put themselves and others at risk of lung cancer and other diseases.

• Reduced Access to Healthcare

Censorship of health information can also make it difficult for people to access healthcare. For example, if people are not aware of the symptoms of a disease, they may not seek medical attention until it is too late. Additionally, if people are not aware of the different treatment options available, they may not be able to make informed decisions about the care they can receive.

• Increased Distrust in Government

When governments censor health information, they are undermining public trust. People are more likely to trust governments that are transparent and accountable. When governments censor information, the public will have a general distrust even if the information is beneficial. Once the line is crossed, the general sentiment is that health experts or government agencies do not have the best interests of the citizens at heart.

How Government Censorship of Health Information Undermines Democracy

Critics of health information censorship argue that it is more important to allow the free flow of information. They advocate sharing information to the public even if that information is controversial or incorrect. Additionally, they argue that censorship undermines public trust and made it more difficult to combat the pandemic.

Further, in a BMJ’s Journal of Medical Ethics peer-reviewed article, a pair of researchers argue that inconsistent messaging around COVID, vaccine mandates and incentivization may have caused vaccine hesitancy and skepticism.

I may further add that government censorship of health information during the pandemic may have increased populism.

Populism is a political ideology that emphasizes the importance of the common citizen and their opposition. The “elites” are often seen as corrupt and out of touch with the concerns of ordinary people.

 Restoring Democracy & Improving Health Outcomes

The best approach to restoring democracy and improving health outcomes will vary depending on the specific circumstances of each state. However, I believe these recommendations are actionable based on what we know and the resources we have today:

• Health Disparities

Health disparities are the differences in disease burden based on income, education, social factors or physical environment. For example, food quality in some neighborhoods is better than others. Food quality plays a role in our health.

This applies to healthcare as well, individuals living in affluent neighborhoods have better access to quality healthcare. Every American citizen should have access to affordable, quality healthcare. It does not have to be universal healthcare.

Expanding healthcare access is possible in many practical ways. Therefore, we must be a delicate balance so that it is easier for people to purchase private health insurance, or maintain Medicaid or Medicare, if qualified. Additionally, this means making sure that prescription drugs prices are competitive, and that people have access to basic preventive care regardless of income, race or social factors.

• Promote Civic Engagement

One of the best ways to strengthen democracy is to encourage civic engagement. This means encouraging people to vote, run for office, and participate in the political process without unnecessary lag. Additionally, when people are engaged in their democracy, they hold their elected officials accountable.

This is the only way a democratic nation can ensure that the government is responsive to their needs.

• Support Independent Media

A free and independent media is important for a healthy democracy. The media plays a vital role in informing the public about important issues and holding the government accountable. It is important to support independent media outlets.

We need independent journalists to report their findings without government intervention.

• Protect Voting Rights

Voting is the cornerstone of a democratic society. Protecting the voting rights of every American citizen makes it easy for all eligible Americans to vote. This includes polling places that are accessible to all voters.

• Address the Root Causes of Health Disparities

Health disparities are a major problem in the United States; it goes beyond healthcare access. Low-income individuals and people living in rural areas are more likely to experience poor health outcomes. It is important to address the root causes of health disparities, including poverty, health policies and disease education. If we do this, America can improve the health of its nation.

Moreover, it is worth mentioning that these are just examples. There is no one-size-fits-all solution. However, local representatives must engage with the public and know the specific needs of their constituents. This will help them to be more effective in serving and building rapport.

Conclusion

Democracy is essential for improving health outcomes. Also, when people have a voice in their government, they can hold their elected officials accountable. This makes them more likely to live in healthy and prosperous communities.

The relationship between democracy and health is complex and multifaceted. There are many ways to restore democracy and improve health outcomes. It is important to take a comprehensive approach that addresses the root causes of health disparities.

The future of our democracy depends on the choices that we make today. We have to be engaged citizens and speak out in defense of democracy- our health depends on it.

Voting is a powerful tool that has created a healthier society for everyone.

I urge you to support organizations that are working to promote democracy and to defend your civil liberties.

Remember, It’s Your Health. Your Vote.

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