Olli Kangas

The role of welfare state principles and generosity in social policy programmes for public health: an international comparative study

BACKGROUND Many important social determinants of health are also the focus for social policies. Welfare states contribute to the resources available for their citizens through cash transfer programmes and subsidised services. Although all rich nations have welfare programmes, there are clear cross-national differences with respect to their design and generosity. These differences are evident in national variations in poverty rates, especially among children and elderly people. We investigated to what extent variations in family and pension policies are linked to infant mortality and old-age excess mortality. METHODS Infant mortality rates and old-age excess mortality rates were analysed in relation to social policy characteristics and generosity. We did pooled cross-sectional time-series analyses of 18 OECD (Organisation for Economic Co-operation and Development) countries during the period 1970-2000 for family policies and 1950-2000 for pension policies. FINDINGS Increased generosity in family policies that support dual-earner families is linked with lower infant mortality rates, whereas the generosity in family policies that support more traditional families with gainfully employed men and homemaking women is not. An increase by one percentage point in dual-earner support lowers infant mortality by 0.04 deaths per 1000 births. Generosity in basic security type of pensions is linked to lower old-age excess mortality, whereas the generosity of earnings-related income security pensions is not. An increase by one percentage point in basic security pensions is associated with a decrease in the old age excess mortality by 0.02 for men as well as for women. INTERPRETATION The ways in which social policies are designed, as well as their generosity, are important for health because of the increase in resources that social policies entail. Hence, social policies are of major importance for how we can tackle the social determinants of health.

Trap for Women or Freedom to Choose? The Struggle over Cash for Child Care Schemes in Finland and Sweden

Debates on welfare reforms have revolved around institutional inertias with the emphasis on institutions as structures. We argue that political discourses work in the same vein and create continuities constraining the array of possible policy options – political frames as carriers of institutional inertia and path dependence. The data are based on political debates on child home care in Finland and Sweden. The ‘trap for women’ frame became dominant in the Swedish discourse, while in Finland ‘freedom to choose’ has been hegemonic. According to the Swedish frame, public day care offers children the best preconditions for later development and enhances social equality, whereas in Finland care at home with all its positive characteristics was contrasted with bureaucratic institutional care. The article highlights how politicians have used these hegemonic discourses to maintain the legitimacy of certain policy options.

Social Policymaking and its Institutional Basis: Transition of the Chinese Social Security System

This article discusses Chinese social policy development in response to the growth of the market economy. It provides a general overview of the systems evolution in three stages: (1) the pre-reform period when a system of enterprise welfare was in operation; (2) a period of system transition; (3) the stage when state welfare began to take shape. These developmental trends are interpreted on the basis of three types of institutional relations: the State-enterprise relation, the enterprise- (or employer-) employee relation, and the individual/worker-State relation. Moreover, the discussion deals with policy perceptions at each stage of the developmental process. Based on these analyses, it illustrates the transformation of the Chinese social security system in a broad socioeconomic and political context, where China struggled to establish a modern, market-based enterprise system. The paper thus expounds issues of socialism, market forces and the power of organized labour.

Coming Late — Catching Up: The Formation of a ‘Nordic Model’

The purpose of this chapter is to provide a historical and comparative framework for the discussion of contemporary social policy developments in the Nordic countries. Present reforms and policy trends illustrate dilemmas for social policy that are common to many countries, and some of the reforms can be seen as alternative strategies to deal with the dilemmas. The relevance of the Scandinavian case for the discussion of different alternative social policy approaches in other parts of the world should be seen in relation to the fact that the Scandinavian model is seen as an ‘ideal type’. Its merits, as well as its drawbacks, deserve to be taken seriously.

Testing old theories in new surroundings: The timing of first social security laws in Africa

This article examines the timing of the introduction of four major social security programmes — work accident insurance, sickness benefits, pensions, and family allowances — in 43 African countries. Further, it explores whether legislative structure, dominant religion or the colonial past of the country is of importance when we control for year of independence, prosperity, degree of democracy, government stability, industrialization and the size and ethnic homogeneity of the population. On the basis of Cox hazard rate modelling it is concluded that industrialized, homogeneous and rather populous countries that were under French rule tend to be pioneers in African social security legislation. issr_1420 73..98

Social Policy and Economic Development in the Nordic Countries: An Introduction

The nineteenth and twentieth centuries witnessed major transformations of economic systems around the world. The first was the creation of capitalist markets in the Western hemisphere. The second was the transition from capitalism to socialism in several countries. The third was the transition in the reverse direction: from centrally planned command systems back to market-based economies. The new globalization of business attached to an explosive expansion of information technologies (ITs) and the rapid IT-based industrialization of the Asian economies may constitute a fourth great transformation that will change the economic order of the globe. During such great transformations, there are always winners and losers. In the wake of such changes, old forms of security vanish and new ones take shape. A crucial issue here is how destructive or constructive change actually becomes. In a Schumpeterian sense, we can speak about a ‘constructive destruction’ (Schumpeter 1950). This term refers to a situation where old, inefficient forms of social activities are destroyed and replaced by more efficient and better systems. An interesting question is how and to what extent different countries, or groups of countries, have managed to harness the destruction, in a socially justifiable way, and to create social and economic institutions that can effectively utilize the potentials and possibilities the new situation creates. How can the Nordic experience be interpreted in this perspective?

Cherry picking: How sensitive is the relationship between inequality and social problems to country samples?

Purpose – In their income inequality theory (IIT), Richard Wilkinson and Kate Pickett posit that income inequality is at the heart of social “ills”. However, their critics argue that the hypothesis is biased and that “cherry picking” is used and support for the IIT is obtained by selecting a suitable sample of countries. The paper aims to discuss these issues. Design/methodology/approach – With a sample of 127 countries, the authors study to what extent the correlation between income inequality and social “ills” varies among countries sampled by geography, religion and income level. Findings – The results of the analysis show that the strength and sometimes the direction of connections between inequality and social “ills” vary according to countries’ cultural background and historical legacies. The IIT is not a universal law. However, it is on a firmer footing than competing explanations. Originality/value – The results contribute both to material and methodological debate on consequences of income inequality.

Does the Most Brilliant Future of the ‘Nordic Model’ Have to be in the Past?

We have in this book tried to explore the transformation of the Nordic countries in the twentieth century from a developmental perspective, with the focus on the role of social policy (cf. Mkandawire 2001). We have observed several reasons for why the emergence and transformation of the ‘Nordic model’ is of interest for the discussion of social policy in developmental perspective. One reason is simply that the Nordic countries have been successful in promoting social policy goals, reducing poverty and inequality while simultaneously increasing employment and social inclusion. We would argue that in the Nordic countries something similar to Schumpeter’s notion of a ‘constructive destruction’ has taken place. Another reason is that each of the Nordic countries is facing dilemmas that are in several respects common to countries in different parts of the world. This second reason is obviously more future oriented: what challenges do the transformation to an ‘information society’ and more global economies pose for the ‘Nordic model’?