Simon Wigley

The Impact of Regime Type on Health: Does Redistribution Explain Everything?

Many scholars claim that democracy improves population health. The prevailing explanation for this is that democratic regimes distribute health-promoting resources more widely than autocratic regimes. The central contention of this article is that democracies also have a significant pro-health effect regardless of public redistributive policies. After establishing the theoretical plausibility of the nondistributive effect, a panel of 153 countries for the years 1972 to 2000 is used to examine the relationship between extent of democratic experience and life expectancy. The authors find that democratic governance continues to have a salutary effect on population health even when controls are introduced for the distribution of health-enhancing resources. Data for fifty autocratic countries for the years 1994 to 2007 are then used to examine whether media freedom—independent of government responsiveness—has a positive impact on life expectancy.

Automaticity, Consciousness and Moral Responsibility

Cognitive scientists have long noted that automated behavior is the rule, while conscious acts of self-regulation are the exception to the rule. On the face of it, automated actions appear to be immune to moral appraisal because they are not subject to conscious control. Conventional wisdom suggests that sleepwalking exculpates, while the mere fact that a person is performing a well-versed task unthinkingly does not. However, our apparent lack of conscious control while we are undergoing automaticity challenges the idea that there is a relevant moral difference between these two forms of unconscious behavior. In both cases the agent lacks access to information that might help them guide their actions so as to avoid harms. In response, it is argued that the crucial distinction between the automatic agent and the agent undergoing an automatism, such as somnambulism or petit mal epilepsy, lies in the fact that the former can preprogram the activation and interruption of automatic behavior. Given that, it is argued that there is elbowroom for attributing responsibility to automated agents based on the quality of their will.

Parliamentary Immunity: Protecting Democracy or Protecting Corruption?

ARECURRING question within contemporary democratic countries relates to whether parliamentary immunity only serves to protect the interests of representatives, rather than the interests of those they were elected to represent. With every act that is suspected of being corrupt (for example, accepting a bribe in return for asking a question or delivering a speech in parliament, failure to declare campaign contributions, insider trading, nepotism etc.), or otherwise illegal (for example, defamation, drunk driving etc.), that is left unexamined by the courts, the justifiability of parliamentary immunity is brought into question. The problem posed by parliamentary immunity is that it affords each representative greater scope to pursue their own personal and political interests, over and above that which is made possible simply by their position of influence. As citizens it is this undemocratic possibility that might incline us to wish for the immunity to be curtailed. The political pressure to circumscribe the immunity is given added impetus by the prevailing public perception that political corruption is widespread.1 Indeed it is increasingly evident that a growing number of countries have either already reduced the scope of parliamentary immunity or are considering doing so.2 The principal rationale behind this trend is that the only telling way to prevent the decision-making

The resource curse and child mortality, 1961–2011

There is now an extensive literature on the adverse effect of petroleum wealth on the political, economic and social well-being of a country. In this study we examine whether the so-called resource curse extends to the health of children, as measured by under-five mortality. We argue that the type of revenue available to governments in petroleum-rich countries reduces their incentive to improve child health. Whereas the type of revenue available to governments in petroleum-poor countries encourages policies designed to improve child health. In order to test that line of argument we employ a panel of 167 countries (all countries with populations above 250,000) for the years 1961-2011. We find robust evidence that petroleum-poor countries outperform petroleum-rich countries when it comes to reducing under-five mortality. This suggests that governments in oil abundant countries often fail to effectively use the resource windfall at their disposal to improve child health.

Parliamentary Immunity in Democratizing Countries: The Case of Turkey

This article examines the effect that shielding elected representatives from criminal law might have in those countries that are undergoing democratization. Parliamentary immunity helps to compensate for any shortfall in the human rights enjoyed by ordinary citizens and provides elected representatives with the protection necessary to rectify that shortfall. However, the immunity may also protect subversive advocacy, rights violations and political corruption. Turkey provides an illuminating case study of those challenges to parliamentary immunity. Drawing on the Turkish experience, it is argued that methods other than exposing parliamentarians to criminal prosecution should be used to counter those problems.

Does control of rheumatic disease raise the standard of living in developing countries

The WHO-ILAR collaborative program on rheumaticdisease (COPCORD) includes all musculoskeletal disease(RD). Studieshavenowbeencompletedinmanydevelopingcountries, and a number of population samples have beenstudied in China, India, the Philippines, and Iran [1]. Thesehave shown that low back pain, knee, neck, and arm painare the most common RD as is also the case in developedcountries [2]. Knee osteoarthritis is a major problem,whereas hip osteoarthritis is rare. Rheumatoid arthritisprevalence in developing countries is about half that ofdeveloped countries. In Han Chinese, osteoarthritis kneeand low back pains are more common in north China thanin the south and in migrants in Malaysia near the equator[3]. This is paralleled by radiological changes, so it is notsimply explained by increased pain sensitivity to cold.World Health Organization estimates of the burden ofdisease expressed as disability adjusted life years (DALYS)are summarized by Brooks [2]. DALYS are the sum ofdisability years lost due to disability and years of life lostdue to mortality, so DALYS would underestimate therelative burden of low mortality disorders such as RD.Thus, RD deserves a much higher priority than currentlyrecognized by WHO and in many national health plans. RDis the most prevalent category of disease in the BighwanCOPCORD study [4]. This study is unique, as it has beencontinued prospectively for 12 years with sustained effortsto improve the prevention, control, and care of RD.A great deal of information has accumulated in theCOPCORD studies. Though this would have been usedlocally to promote health care for RD, it is now necessaryto take an overview of the data with respect to alldeveloping countries. We have no COPCORD data fromSub-Saharan Africa where the problems are formidable andresources are minimal.There is an increasing opportunity for the prevention ofRD [5, 6]. This will depend mainly on education, whichshould cost less than treatment and rehabilitation.The major question now is how to raise the level ofcontrol of RD in a cost-effective manner, bearing in mindthe limited economic and skill resources of developingcountries. Chronic disabling conditions impair ability toprogress in education and to be efficient in the work forceand require support from fit members of society, as withcare of the aged. This has been demonstrated by economists[7, 8]. They argue that an increase in life expectancy as aresult of exogenous health interventions means that morepeople must share a limited supply of resources. Doublinglife span could mean that double the number would have toshare the limited amount of food with a decrease in health,economic level, and a rise in poverty. Contrary to expect-

The impact of democracy and media freedom on under-5 mortality, 1961–2011

Do democracies produce better health outcomes for children than autocracies? We argue that (1) democratic governments have an incentive to reduce child mortality among low-income families and (2) that media freedom enhances their ability to deliver mortality-reducing resources to the poorest. A panel of 167 countries for the years 1961-2011 is used to test those two theoretical claims. We find that level of democracy is negatively associated with under-5 mortality, and that that negative association is greater in the presence of media freedom. These results are robust to the inclusion of country and year fixed effects, time-varying control variables, and the multiple imputation of missing values.

Experimental Philosophy: An Introduction by Joshua Alexander. Cambridge: Polity Press, 2012. 154pp., £15.99, ISBN 978 0 7456 4918 4

This book is a collection of texts by Jeffrey C. Alexander, most of which have been previously published as book chapters or journal articles. Alexander sums up his ideas and criticisms of modern thought, which he divides into four elements: ‘philosophy, psychology, art and social engineering’ (p. 10). His focus is on the negative effects side of modernity, whereof the gloomy title of the book. This intellectual exploration brings forth an argument that modernity is indeed two-dimensional – evil and good – and at the same time both backwardand forward-looking. Modernity, in other words, incites, encourages and produces the best and the worst kinds of social behaviour. This comprises technological and medical advances, the successful welfare systems and public education institutions, but it also includes the potential for violence of cataclysmic proportions, mass killings and limited freedoms (pp. 54–61). This guiding premise is critically engaged throughout the book. Alexander contrasts progress with debauchery in relation to the material and moral human condition. He analyses Weber’s understanding of rationality (pp. 45–9) and the process of rationalisation as an example of modern intellectual struggle where reason and faith are constantly in conflict, and where faith will inevitably lose. Rationalisation came to be a process that ultimately objectified people in order to dominate them, replacing the old forms of domination with modern ones: isolation and cultural abandonment (p. 53). Throughout the chapters, alongside demonstrating the looming darkness within (post-)modernity, Alexander also suggests ways of overcoming the deep flaws embedded in it (pp. 76–7). By analysing various points of tension in modernity Alexander points to potential ways we, as a society, could amend and diffuse the tensions. He invokes Simmel’s notion of strangeness as one element of tension, wherein a variety of opposing groups in a society seek to dehumanise the other, thus rendering them the enemy to be destroyed (pp. 95–8). These tensions are seemingly inherent and essentially a necessary part of human imagination and subsequent socialisation rooted in our conceptions of good and evil (pp. 110–22). As a sociological theorist and functionalist, Alexander gives much attention to civil society and its ability to absorb, discuss and resolve much of the noted tensions. The healing process within which the darkness of modernity can be ameliorated involves individual self-repair and introspection, collective insistence on improving human rights, social mobilisation and social criticism, but also developing international institutions that would facilitate various locally produced capacities to assuage tensions. This book offers a highly engaging and insightful overview of modernity with one major flaw – it is too short.

Book Review: General Politics: Population and Political Theory: Philosophy, Politics and Society 8Population and Political Theory: Philosophy, Politics and Society 8 by FishkinJames S. and GoodinRobert E. (eds). Chichester: Wiley-Blackwell, 2010. 317pp., £60.00, ISBN 978 1 4443 3038 0

added Keynes’ theoretical framework to certain uncontested maxims of macroeconomic and microeconomic thought. The result fatally compromised the ‘Neoclassical Synthesis’ and the economic and political systems built on it gave way in the 1970s to the rise of deregulation and the influence of the monetarists led by Milton Friedman. The authors attempt to right this wrong by advocating a return to a Keynesian orthodoxy that brooks no compromise with the widely accepted neoclassical suppositions of supply and demand and self-correcting market mechanisms. Instead, a further refined understanding of Keynesian views on effective demand, value, output and employment must be doggedly pursued. As an apologia for a refined Keynesian framework, this work does an excellent job of laying out the pro-Keynesian arguments. However, the overall message is hampered by unnecessary duplication of material and a sometimes strident tone. Several sections also have a dated feel since they have already been overtaken by events. Despite these shortcomings, academics, analysts and policy makers will be well served to consider Eatwell and Milgate’s view of a Keynesian response to the current economic situation in order to understand better the interventionist fiscal and monetary responses being debated so heatedly today.

Book Review: General Politics: Population and Political Theory: Philosophy, Politics and Society 8

added Keynes’ theoretical framework to certain uncontested maxims of macroeconomic and microeconomic thought. The result fatally compromised the ‘Neoclassical Synthesis’ and the economic and political systems built on it gave way in the 1970s to the rise of deregulation and the influence of the monetarists led by Milton Friedman. The authors attempt to right this wrong by advocating a return to a Keynesian orthodoxy that brooks no compromise with the widely accepted neoclassical suppositions of supply and demand and self-correcting market mechanisms. Instead, a further refined understanding of Keynesian views on effective demand, value, output and employment must be doggedly pursued. As an apologia for a refined Keynesian framework, this work does an excellent job of laying out the pro-Keynesian arguments. However, the overall message is hampered by unnecessary duplication of material and a sometimes strident tone. Several sections also have a dated feel since they have already been overtaken by events. Despite these shortcomings, academics, analysts and policy makers will be well served to consider Eatwell and Milgate’s view of a Keynesian response to the current economic situation in order to understand better the interventionist fiscal and monetary responses being debated so heatedly today.