Association of rule of law and health outcomes: an ecological study

ObjectivesTo explore whether the rule of law is a foundational determinant of health that underlies other socioeconomic, political and cultural factors that have been associated with health outcomes.SettingGlobal project.ParticipantsData set of 96 countries, comprising 91% of the global population.P...

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Bibliographic Details
Published in:BMJ open 2015-01, Vol.5 (10), p.e007004-e007004
Main Authors: Pinzon-Rondon, Angela Maria, Attaran, Amir, Botero, Juan Carlos, Ruiz-Sternberg, Angela Maria
Format: Article
Language:English
Subjects:
Adult
Aged
Cardiovascular Diseases - mortality
Child mortality
Corruption
Criminal Law
Developing Countries
Diabetes Mellitus - mortality
Drug overdose
Ecological studies
Economic growth
Female
GDP
Global Health
Government
Gross Domestic Product
Health Status Indicators
Human Rights
Humans
Income inequality
Industrialized nations
Infant
Infant Mortality
Jurisprudence
Law Enforcement
LDCs
Life Expectancy
Macroeconomics
Maternal Mortality
Mortality
Pregnancy
Public health
Rule of law
Social Determinants of Health - legislation & jurisprudence
Society
Socioeconomic Factors
Whistleblowing
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Summary:ObjectivesTo explore whether the rule of law is a foundational determinant of health that underlies other socioeconomic, political and cultural factors that have been associated with health outcomes.SettingGlobal project.ParticipantsData set of 96 countries, comprising 91% of the global population.Primary and secondary outcome measuresThe following health indicators, infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, were included to explore their association with the rule of law. We used a novel Rule of Law Index, gathered from survey sources, in a cross-sectional and ecological design. The Index is based on eight subindices: (1) Constraints on Government Powers; (2) Absence of Corruption; (3) Order and Security; (4) Fundamental Rights; (5) Open Government; (6) Regulatory Enforcement, (7) Civil Justice; and (8) Criminal Justice.ResultsThe rule of law showed an independent association with infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, after adjusting for the countries’ level of per capita income, their expenditures in health, their level of political and civil freedom, their Gini measure of inequality and women's status (p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2014-007004