Politics and health outcomes: A path analytic approach

Int J Health Plann Manage. 2019 Jan;34(1):e824-e843. doi: 10.1002/hpm.2699. Epub 2018 Nov 8.


Social and health policies and political participation are associated with each political tradition related to public health outcomes. However, there is a lack of evidence for the relationship between policy and outcomes. This study seeks to determine the relationship between politics, labour and welfare state indicators, economic inequality, and health outcome indicators. Data to test the model was obtained from the Turkish Statistical Institute (TurkStat) that belongs to the 81 provinces of Turkey. Path analysis was used to model the associations between policy, labour and welfare states, economic inequality, and health outcomes. To test the goodness of fit of the model, multiple criteria of model fit indices were utilised. The fit of the respecified path analytic model data is good (normed fit index [NFI] is 0.91, comparative fit index [CFI] is 0.92, goodness of fit index [GFI] is 0.91, and adjusted goodness of fit index [AGFI] is 0.93). Study results illustrate a strong relationship between voter partisanship, employment rate, satisfaction from both social security and health services, and life expectancy at birth and mortality. These results represent an important step towards understanding the elusive relationship between policy and health outcomes. Designing socially inclusive policies, considering labour market opportunities, and enhancing the population's well-being are advisable strategies for policymakers who wish to optimise public health outcomes.

Keywords: Turkey; health outcomes; path analysis; politics.

MeSH terms

  • Databases, Factual
  • Health Policy*
  • Humans
  • Outcome Assessment, Health Care* / statistics & numerical data
  • Politics*
  • Public Health / statistics & numerical data
  • Socioeconomic Factors
  • Turkey
  • Workforce / statistics & numerical data