Democracy and Health

QJM: Medical Journal, Vol. 98, pp. 299-304, 2005

6 Pages Posted: 12 Dec 2006

See all articles by Jennifer Prah Ruger

Jennifer Prah Ruger

University of Pennsylvania - School of Social Policy & Practice; University of Pennsylvania - Perelman School of Medicine


Scholars of population and global health have grappled for decades with the complex relationship between health and its determinants. It is important to extend our analysis to broad structural factors, such as political institutions, however, to better understand global health inequalities. A country's political structure affects virtually every aspect of society, including health. While much can be said about the link between politics and health, this Article examines one aspect of this relationship - the impact of key democratic principles on health. After offering a philosophical framework that links democracy and health, it analyses three major public health events in China: the 1958-1961 famine, the SARS epidemic, and the emerging threat of HIV/AIDS. These three case studies explore the idea that a lack of democratic institutions, especially a free press and multiparty elections, can have deleterious effects on health. These case studies highlight factors that are essential for preventing a full-blown HIV/AIDS epidemic in China: new and better standards of public accountability; an international imperative to cooperate globally to ensure health; freely available information about disease prevention, control, and treatment; protection of individual rights and freedom of assembly, association and expression; and the ability to voice complaints and opposition. By instituting these rights in a timely fashion, China may be able to contain the HIV/AIDS epidemic before it loses millions of its citizens to yet another public health tragedy.

Keywords: HIV, AIDS, Democracy, Health

JEL Classification: I10

Suggested Citation

Prah Ruger, Jennifer, Democracy and Health. QJM: Medical Journal, Vol. 98, pp. 299-304, 2005, Available at SSRN:

Jennifer Prah Ruger (Contact Author)

University of Pennsylvania - School of Social Policy & Practice ( email )

3701 Locust Walk
Philadelphia, PA 19104-6214
United States

University of Pennsylvania - Perelman School of Medicine

423 Guardian Drive
Philadelphia, PA 19104
United States

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