The debate over how much governments should intervene in the economy to support citizens is a constant feature of modern politics. Recent years of pandemic recovery and shifting budgets have renewed public interest in how social policies affect everyday life. Much of this conversation centers on economic outcomes, such as employment rates or inflation.
A recent study investigates a more fundamental question by examining how these social policies relate to human longevity. Writing in Social Indicators Research, researchers analyzed multiple decades of data to see if generous welfare institutions are linked to the quantity and health of human lives. The authors found that countries with stronger social safety nets tend to have longer life expectancies and lower maternal mortality rates.
Expanding the Global Picture
Scholars have spent decades studying the effects of the welfare state. In recent years, researchers have frequently explored how government intervention relates to subjective well-being, usually by measuring self-reported happiness or life satisfaction.
The authors of this new paper identify two main limitations in that existing body of work. First, the research has overwhelmingly focused on high-income nations, particularly members of the Organisation for Economic Co-operation and Development (OECD). Second, it has primarily measured subjective feelings rather than objective health outcomes.
To address these gaps, researchers Francesco Bromo of the University of Oxford, Alexander C. Pacek of Texas A&M University, and Benjamin Radcliff of the University of Notre Dame broadened the scope. They collected data spanning from 1990 to 2023 for a wide range of low-, middle-, and high-income countries. Their goal was to see if the trends observed in wealthy democracies also apply to countries at different stages of economic development.
The authors propose a sequence of events to explain how social programs might influence longevity. They argue that welfare policies reduce poverty and expand access to educational and medical resources. These improved conditions help reduce chronic psychological and physical stress, which in turn leads to better population health and longer lifespans.
Evaluating Institutions and Outcomes
To measure the generosity of a country’s welfare institutions, the researchers used the Bertelsmann Stiftung’s Transformation Index. This index relies on expert assessments to rate countries on a scale from 1 to 10. Higher scores indicate stronger social safety nets, greater equality of opportunity, and a better institutional capacity to mitigate socioeconomic risks.
The researchers compared these index scores against several objective health metrics. These included life expectancy at birth, the number of healthy life years a population can expect to live, and the maternal mortality ratio. They also looked at life expectancy inequality, which measures the gap in mortality ages across a single population.
The analysis relied on two different statistical approaches covering the years 2006 to 2022. First, the researchers used pooled panel models to compare conditions across different countries. Then, they used models that account for stable differences between countries and common global trends. This second approach allowed them to see how changes in a single country’s welfare regime over time related to changes in its longevity metrics.
To ensure their results were not skewed by other factors, the authors controlled for several variables. These included gross domestic product (GDP) per capita, unemployment rates, and public health expenditure as a share of the economy. They also accounted for demographic factors like the ratio of older dependents to working-age citizens.
Longer Lives and Lower Mortality
Across all the models tested, the researchers found a consistent directional relationship. More generous welfare regimes are associated with longer overall life expectancy. The association holds true when measuring male and female life expectancies separately.
The data also revealed links to the quality and distribution of those years. Higher welfare index scores were linked to an increase in healthy life years. At the same time, stronger safety nets were associated with lower inequality in life expectancy, meaning fewer disparities in how long people within a single society manage to live.
The impact on maternal mortality was also notable. The pooled cross-national models showed that a one-point increase in the welfare index score was associated with a roughly 17 percent reduction in the maternal mortality ratio. The authors note that maternal mortality reflects a society’s broader public health capacity and its ability to protect people during periods of heightened physical vulnerability.
While the exact numbers varied depending on the statistical model used, the direction of the trend remained stable. The broader cross-national comparisons yielded larger numerical estimates than the models tracking changes within individual countries. In both cases, the presence of stronger welfare institutions pointed toward better longevity outcomes.
Tracing Country Trajectories
To provide real-world context for these statistical estimates, the researchers highlighted specific countries that experienced major changes in their welfare index scores. Algeria, Angola, Bhutan, Kenya, Liberia, and Uganda all saw their index scores rise by two points or more during the study period.
In every one of these six countries, the improved welfare scores were accompanied by increased life expectancy and more healthy life years. In Angola, for instance, a two-point rise in the welfare index coincided with an increase in overall life expectancy of more than 22 years. These nations also saw notable declines in maternal mortality and life expectancy inequality.
The researchers also looked at countries where the welfare state contracted. Libya experienced the largest reduction in its welfare score, dropping by 4.5 points. During that time, the country saw a decline in healthy life years and an increase in maternal mortality and life expectancy inequality.
However, the authors point out that retrenchment does not always trigger an immediate decline across every metric. Syria experienced a 3.5-point drop in its welfare score and an increase in life expectancy inequality. Despite this, the country still recorded marginal improvements in overall life expectancy and maternal mortality during the same timeframe.
Identifying the Boundaries
The study authors explicitly state that their findings outline associations rather than definitive proof of cause and effect. Because the research is observational, it is possible that other unaccounted historical or political developments influenced the health outcomes in the studied countries. The statistical models control for many economic factors, but they cannot entirely eliminate the possibility of outside influences.
The reliance on a broad expert assessment index also presents certain limitations. The measurement captures the overall structure and functioning of a country’s welfare institutions. Because it evaluates the system as a whole, the data cannot identify which specific policy instruments or spending categories have the greatest impact on population health.
