What's wealth got to do with it: A multilevel global comparative analysis on social investments and individual health

Previous research reports associations between social investments and health. These studies usually focus exclusively on Western countries. A need exists for health and social investment research that delves beyond Western Europe and North America. Association between welfare regimes and its effect on individual health is explored globally. The role of socioeconomic factors is also examined. The most recent World Health Survey data are used (n=218,608). Main outcomes include self-rated health and disability. The main predictor variable is welfare regime. Regimes are formulated using the Wood and Gough typology. Multilevel logistic regression is used to investigate links between individual health and welfare regimes, while also analyzing factors on the contextual and personal level (i.e., national wealth, female literacy, occupation, and education). People in state-organized welfare regimes reported better health as compared to non-state regimes (i.e. informal and insecurity regimes). For example, odds ratio (OR) for the prevalence of poor health for the insecurity-regime was 1.58 (95%CI 1.09-2.30). Accounting for socioeconomic factors resulted in non-state regimes reporting better health. For instance, the OR for the insecurity-regime became 0.61 (95%CI 0.26-1.43). Variations in personal health between non-state regimes were minute. However, for disability, evidence suggested less disability in “productivist” regimes, OR for prevalence of disability was 0.94 (95%CI 0.45-1.99) as compared to other non-state regimes. Socioeconomic factors explain variations in personal health between welfare regimes, but variations remain. However, for disability, there is indication of less disability in “productivist” regimes as prevalence of disability is lower in comparison to other non-state regimes.