Person:

Hall, Peter

Background. – The objective of this study is to outline a capabilities approach to the social determinants of population health and to compare its explanatory power and implications for public policy-making with psychosocial approaches. Methods. – A model linking the structures of economic and social relations to health outcomes is developed and logistic methods used to confirm its base validity for a representative sample of 16,488 citizens in 19 developed democracies drawn from the World Values Surveys of 1990 and 2005. Self-reported health is the dependent variable. Age, gender, education, employment status, self-mastery, income, autonomy at work, ties to family and friends, subjective social status, associational memberships and sense of national belonging are considered. † Results. – At baseline, risk ratios reflecting movement from the 25th to 75th percentile in the distribution of the variable indicate that increases in income reduce the likelihood of poor health (0.78; 0.73-0.82) as does higher autonomy at work (0.90; 0.85-0.94) but so does access to social resources reflected in ties to family and friends (0.89; 0.86-0.92), associational memberships (0.93; 0.89-0.98), subjective social status (0.77; 0.54-0.90) while the absence of feelings of national belonging increases the likelihood of poor health (1.14; 1.06-1.23). Conclusion – The results suggest that population health is dependent on the distribution of social as well as economic resources along the dimensions predicted by a capabilities model. Governments should be attentive to the impact of policy on the distribution of social, as well as economic, resources.

Contemporary approaches to varieties to capitalism are often criticized for neglecting issues of institutional change. This paper develops an approach to institutional change more extended than the one provided in Hall and Soskice (in Varieties of Capitalism: The Institutional Foundations of Comparative Advantage, Oxford, Oxford University Press, 2001) but congruent with its varieties-of-capitalism perspective. It begins by outlining an approach to institutional stability, which suggests that the persistence of institutions depends not only on their aggregate welfare effects but also on the distributive benefits that they provide to the underlying social or political coalitions; and not only on the Pareto-optimal quality of such equilibria but also on continuous processes of mobilization through which the actors test the limits of the existing institutions. It then develops an analysis of institutional change that emphasizes the ways in which defection, reinterpretation and reform emerge out of such contestation and assesses the accuracy of this account against recent developments in the political economies of Europe. The paper concludes by outlining the implications of this perspective for contemporary analyses of liberalization in the political economy.