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Dying of corruption

Published online by Cambridge University Press:  01 September 2010

Sören Holmberg*
The Quality of Government Institute, Department of Political Science, University of Gothenburg, Gothenburg, Sweden
Bo Rothstein
The Quality of Government Institute, Department of Political Science, University of Gothenburg, Gothenburg, Sweden
*Correspondence to: Sören Holmberg, The Quality of Government Institute, Department of Political Science, University of Gothenburg, Box 711, Gothenburg SE 405 30, Sweden. Email:


In many poor countries, over 80% of the population have experienced corrupt practices in the health sector. In rich countries, corruption takes other forms such as overbilling. The causal link between low levels of the quality of government (QoG) and population health can be either direct or indirect. Using cross-sectional data from more than 120 countries, our findings are that more of a QoG variable is positively associated with higher levels of life expectancy, lower levels of mortality rates for children and mothers, higher levels of healthy life expectancies and higher levels of subjective health feelings. In contrast to the strong relationships between the QoG variables and the health indicators, the relationship between the health-spending measures and population health are rather weak most of the time and occasionally non-existent. Moreover, for private health spending as well as for private share of total health spending, the relation to good health is close to zero or slightly negative. The policy recommendation coming out of our study to improve health levels around the world, in rich countries as well as in poor countries, is to improve the QoG and to finance health care with public, not private, money.

Copyright © Cambridge University Press 2010

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Acemoglu, D.Robinson, J. (2008), The Role of Institutions in Growth and Development, Washington, DC: The World Bank (on behalf of the Commission on Growth and Development).Google Scholar
Anbarci, N., Escaleras, M.Register, C. A. (2009), ‘The ill effects of public sector corruption in the water and sanitation sector’, Land Economics, 85(2): 363377.CrossRefGoogle Scholar
Angell, M. 2009. Drug Companies and Doctors: A Story of Corruption. The New York Review of Books, 11 February: 8–12.Google Scholar
Baldacci, E., Clements, B., Gupta, S.Cui, Q. A. (2008), ‘Social spending, human capital, and growth in developing countries’, World Development, 36(8): 13171341.CrossRefGoogle Scholar
Barr, N. (2004), The Economics of the Welfare State, 4th ed, Oxford: Oxford University Press.Google Scholar
Bayliss, K. (2003), ‘Utility privatisation in Sub-Saharan Africa: a case study of water’, Journal of Modern African Studies, 41(4): 507531.CrossRefGoogle Scholar
Bloom, D. E.Canning, C. (2000), ‘The health and wealth of nations’, Science, 287(5456): 12071209.CrossRefGoogle ScholarPubMed
Bruns, B. R.Meinzen-Dick, R. S. (2000), Negotiating Water Rights, London: Intermediate Technology.CrossRefGoogle Scholar
Diamond, L. (2007), ‘A quarter-century of promoting democracy’, Journal of Democracy, 18(4): 118120.Google Scholar
Dugger, C. W. 2005. Where a Cuddle With Your Baby Requires a Bribe. The New York Times, August 30.Google Scholar
Evans, P. B. (2009), ‘Population Health and Development: An Institutional-Cultural Approach to Capability Expansion’, in P. A. Hall and M. Lamont (eds), Successful Societies. How Institutions and Culture Affect Health, New York: Cambridge University Press, 104127.CrossRefGoogle Scholar
Gleditsch, K. S. (2002), ‘Expanded trade and GDP data’, Journal of Conflict Resolution, 46: 712724.CrossRefGoogle Scholar
Gupta, S., Davoodi, H.Tiongson, E. (2000), Corruption and the Provision of Health Care and Education Services, Working Paper. Washington, DC: International Monetary Fund.Google Scholar
Hall, P. A.Lamont, M. (eds) (2009), Successful Societies: How Institutions and Culture Affect Health, New York: Cambridge University Press.CrossRefGoogle Scholar
Hall, P. A.Taylor, R. C. R. (2009), ‘Health, Social Relations, and Public Policy’, in P. A. Hall and M. Lamont (eds), Successful Societies: How Institutions and Culture Affect Health, New York: Cambridge University Press, 82103.CrossRefGoogle Scholar
Helliwell, J. F.Huang, H. F. (2008), ‘How’s your government? International evidence linking good government and well-being’, British Journal of Political Science, 38: 595619.CrossRefGoogle Scholar
Klomp, Haan, J. (2008), ‘Effects of governance on health: a cross-national analysis of 101 countries’, Kyklos, 61(4): 599614.CrossRefGoogle Scholar
Kornai, J. (2000), Hidden in an Envelope. Gratitude Payments to Medical Doctors in Hungary, Budapest: Collegium Budapest Institute for Advanced Study.Google Scholar
Krishna, A. (2006), Reversal of Fortune. Foreign Policy May–June 2006.Google Scholar
Krishna, A. (2007), ‘Poverty and health: defeating poverty by going to the roots’, Development, 50(2): 6369.CrossRefGoogle Scholar
Lazarova, E.Mosca, I. (2008), ‘Does governance matter for aggregate health capital?’, Applied Economics Letters, 15(3): 599614.CrossRefGoogle Scholar
Lewis, M. (2006), Governance and Corruption in the Public Health Sector. Working Paper no. 78. Washington, DC: Center for Global Development.Google Scholar
Lewis, C. M.Lloyd-Sherlock, P. (2009), ‘Social policy and economic development in South America: an historical approach to social insurance’, Economy and Society, 38(1): 109131.CrossRefGoogle Scholar
Lindstrom, M.Mohseni, M. (2009), ‘Social capital, political trust and self-reported psychological health: a population-based study’, Social Science and Medicine, 68(3): 436443.CrossRefGoogle ScholarPubMed
March, J. B.Olsen, J. P. (1989), Rediscovering Institutions: The Organizational Basis of Politics, New York: Basic Books.Google Scholar
Marmot, M. (2004), The Status Syndrome: How Social Standing Affects Our Health and Longevity, New York, NY: Henry Holt.CrossRefGoogle Scholar
Menon-Johansson, A. (2005), ‘Good governance and good health: the role of societal structures in the human immunodeficiency virus pandemic’, BMC International Health and Human Rights, 5(1): 96111.CrossRefGoogle ScholarPubMed
North, D. C. (1990), Institutions, Institutional Change and Economic Performance, Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Ostrom, E. (1990), Governing the Commons: The Evolution of Institutions for Collective Action, New York: Cambridge University Press.CrossRefGoogle Scholar
Rajkumar, A. S.Swaroop, V. (2008), ‘Public spending and outcomes: does governance matter?’, Journal of Development Economics, 86(1): 96111.CrossRefGoogle Scholar
Rothstein, B.Eek, D. (2009), ‘Political corruption and social trust – an experimental approach’, Rationality and Society, 21(1): 81112.CrossRefGoogle Scholar
Rothstein, B.Teorell, J. (2008), ‘What is quality of government: a theory of impartial political institutions’, Governance – an International Journal of Policy and Administration, 21(2): 165190.CrossRefGoogle Scholar
Rothstein, B. (2010), ‘Anti-corruption. The indirect “big bang” approach’, Review of International Political Economy (forthcoming).Google Scholar
Savedoff, W. D.Hussmann, K. (2006), ‘Why Are Health Systems Prone to Corruption’, in Global Corruption Report 2006: Transparency International, London: Pluto.Google Scholar
Scholz, J. T.Lubell, M. (1998), ‘Trust and taxpaying: testing the heuristic approach to collective action’, American Journal of Political Science, 42(2): 398417.CrossRefGoogle Scholar
Schultz, J., O’Brien, A. M.Tadesse, B. (2008), ‘Social capital and self-rated health: Results from the US 2006 social capital survey of one community’, Social Science and Medicine, 67(4): 606617.CrossRefGoogle ScholarPubMed
Siegrist, J.Marmot, M. (2006), Social Inequalities in Health: New Evidence and Policy Implications, Oxford: Oxford University Press.CrossRefGoogle Scholar
Sjöstedt, M. (2008), Thirsting for Credible Commitments: How Secure Land Tenure Affects Access to Drinking Water in Sub-Saharan Africa, Göteborg Studies in Politics, 110, Gothenburg: Department of Political Science, University of Gothenburg.Google Scholar
Stockholm International Water Institute (2006), Corruption in the Water Sector: Causes, Consequences and Potential Reform, Stockholm: Stockholm International Water Institute (SIWI).Google Scholar
Teorell, J., Holmberg, S., Rothstein, B. (2008), The Quality of Government Dataset, version 15 May 2008, University of Gothenburg: The Quality of Government Institute. [3 June 2010].Google Scholar
Transparency International (2008), Global Corruption Report 2008: Corruption in the Water Sector, Cambridge: Cambridge University Press.Google Scholar
Wagstaff, A.Claeson, M. (2004), Rising to the Challenge. The Millenium Goals for Health, Washington, DC: The World Bank.Google Scholar
World Bank (2010), Silent and Lethal: How Quiet Corruption Undermines Africa’s Development Efforts, Washington, DC: The World Bank.Google Scholar
Widmalm, S. (2008), Decentralisation, Corruption and Social Capital: From India to the West, Thousand Oaks: SAGE Publications.CrossRefGoogle Scholar
Wilkinson, R. G.Pickett, K. (2009), The Spirit Level: Why More Equal Societies Almost Always do Better, London: Allen Lane.Google Scholar