The association between social development and population health: a cross-sectional study across countries of different economic growth

Abstract

Background: Social Determinants of Health (SDH) are important in explaining why some countries enjoy better health than others. This empirical study highlights controversies in the literature on the relationship between socioeconomic development and health, and investigates how the relationship might vary in countries with different economic growth.

Methods: The sample consists of 172 countries, and recent cross-sectional data was collected from the World Bank's "Data Bank". Population health was proxied with life expectancy, infant mortality and under-five mortality, and sociooeconomic conditions were expressed with GNI/capita, unemployment rate, poverty, Gini index, educational attainment, public spending on health and physician density. Countries were categorized into three groups as low / lower middle-, upper middle- and high-income according to World Bank thresholds. Ordinary least squares regression was used to model the relationships.

Results: The association between socioeconomic conditions and health differed between countries of different economic development. Poverty, educational attainment, income inequality, and physician density were the strongest contributors to health. Higher economic development had a stronger relationship with health in richer countries, and government commitment to health care in poorer ones.

Conclusion: Based on evidence from studies such as this one, researchers and policymakers globally could commit to acting together on SDH, and to aligning resources from different sectors to formulate interventions aiming to improve population health.

Keywords: Health inequities; Health policy; National income; Population health; Social determinants of health; Socioeconomic status.

Fig. 1

Relative contribution of SDH to population  health indicators, by country income