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Why do some societies fare well, and others poorly, at reducing the risk of early death? Wealth, Health, and Democracy in East Asia and Latin America finds that the public provision of basic health care and other inexpensive social services has reduced mortality rapidly even in tough economic circumstances, and that political democracy has contributed to the provision and utilization of such social services, in a wider range of ways than is sometimes recognized. These conclusions are based on case studies of Argentina, Brazil, Chile, Costa Rica, Indonesia, South Korea, Taiwan, and Thailand, as well as on cross-national comparisons involving these cases and others. James W. McGuire is professor in the Department of Government at Wesleyan University. He specializes in comparative politics with a regional focus on Latin America and East Asia and a topical focus on democracy and public health. He is the author of Peronism without Perón: Unions, Parties, and Democracy in Argentina and is a recipient of Wesleyan’s Binswanger Prize for Excellence in Teaching.Read more
- Integrates political science and public health analysis
- Argues that mortality decline should be given more prominence as a criterion of national development
- Interweaves historical analysis of eight East Asian and Latin American societies with comparisons among the eight societies
Reviews & endorsements
“McGuire demonstrates that democracies are better at providing ‘good health at low cost’ than are less-free political systems. His thorough work also puts the capstone on a large and consistent body of research showing that a population need not be rich to be healthy.”
– Health AffairsSee more reviews
“McGuire’s major contribution is the combination of quantitative analysis with a detailed qualitative investigation of the institutional framework of eight countries in Latin America and East Asia. This enables him to explain anomalies, such as the Chilean case, in which an authoritarian government during a period of declining GDP presided over a dramatic drop in infant mortality (1973-84)…Highly recommended.”
– J. Gerber, San Diego State University, Choice
“The main competing hypotheses are ‘wealthier is healthier,’ which sees higher incomes as the main driving force, and the social service provision alternative, which emphasizes the importance of government delivery of basic services related to health, education, family planning, safe water, and sanitation. Cross-national data show reasonably strong correlation between GDP per capita and infant mortality—supporting the first hypothesis—but only very weak correlation between growth in GDP per capita and rate of decline in mortality—which is consistent with the second hypothesis. This volume brings a fresh perspective to the debate by combining and integrating public health and political science perspectives.”
– John Bongaarts, Vice President and Distinguished Scholar, Population Council, Population and Development Review
“Wealth, Health and Democracy is an excellent study of the determinants of social policy and development outcomes in the global south… The implications of Wealth, Health and Democracy are powerful and provocative. The insights gained from this study are plenty. By unpacking the monolithic idea of the welfare state, McGuire teaches us that in fact the social policies that have the most impact in the context of the global south feasible.”
– Joseph Wong, University of Toronto, Governance
“Methodologically, this book is a gem. In addition to providing rich historical case studies, drawn from a plethora of sources ranging from archival materials to in-depth interviews, McGuire includes an impressive array of statistical data…McGuire does a commendable job of carefully blending rigorous statistical analyses with in-depth qualitative evidence. Given the dearth of studies conducting this kind of methodological approach, this book is a must-read for any political scientist working on comparative public health policy.”
– Eduardo J. Gómez, Rutgers University, Journal of Health Politics, Policy and Law
“Infant mortality tells us a tremendous amount about a society. To what extent does the government care about the most vulnerable? No one has plumbed the determinants of infant mortality across countries better than James McGuire. In this compelling study, McGuire scrupulously shows that economic growth is not enough to reduce infant mortality; effective delivery of social services matters. Moreover, he shows that democracy is important as well. Sustained democratic rule creates a culture more conducive to the expansion of human capabilities. A powerful piece of social science.”
– Stephan Haggard, University of California San Diego
“This is an impressive book that drives home an extremely important argument: Provision of comparatively low-cost public health services is a more effective way of lowering premature mortality than reliance on economic growth, and democracy over the long run favors provision and utilization of these services. McGuire musters massive amounts of evidence, which makes the book a goldmine for scholars and students interested in development in general as well as in country studies.”
– Evelyne Huber, University of North Carolina, Chapel Hill
“James McGuire has produced an outstanding, and in many respects pathbreaking, book. It is important not only because of its theoretical and analytical contributions, which are considerable, but also because it has major policy implications about an issue of fundamental social importance: keeping infants alive. He argues persuasively that countries do not need high growth or large welfare states to lower mortality; relatively inexpensive and non-controversial primary health programs can have a striking impact. McGuire skillfully melds together an extensive literature on public health policy with political science literature on regime type, interest groups, and international influences. The book will be of considerable interest both to the policy community and to academic research audiences in political science, economics, and sociology.”
– Robert Kaufman, Rutgers University
“Political science has focused too exclusively on the creation and operation of institutions and has examined too little the policy outputs and outcomes that they produce. In this unique and impressive book, James McGuire helps to rectify this stark imbalance by investigating the impact of democracy and of specific policy programs on basic health issues. The broad, cross-regional scope of the analysis and the depth of the research are exceptional. I am highly impressed by the mastery of detail, the comprehensiveness of the analysis, and McGuire’s capacity to put it all together as a vast canvas. This book is certain to have an important place in the scholarly literature.”
– Kurt Weyland, University of Texas, Austin
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- Date Published: March 2010
- format: Paperback
- isbn: 9780521139342
- length: 426 pages
- dimensions: 234 x 156 x 24 mm
- weight: 0.65kg
- contains: 3 b/w illus. 27 tables
- availability: Available
Table of Contents
1. Incomes, capabilities, and mortality decline
2. Democracy, spending, services, and survival
3. Costa Rica: a healthy democracy
4. Chile: the pinochet paradox
5. Argentina: big welfare state, slow infant mortality decline
6. Brazil: from laggard to leader in basic health service provision
7. Taiwan: from poor but healthy to wealthy and healthy
8. South Korea: small welfare state, fast infant mortality decline
9. Thailand: democratization speeds infant mortality decline
10. Indonesia: authoritarianism slows infant mortality decline
11. Wealth, health, democracy, and mortality.
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