Welfare state decommodification and population health.

Abstract

A generous welfare state decommodifies social relations and frees citizens from relying excessively on markets. We argue that decommodification is associated with population health in two ways: directly, as it provides better social protection to households and indirectly, as it mitigates health-damaging labour market polarization and reduces the incidence of labour market risks. Using time-series cross-sectional quantitative analysis for 21 OECD countries from 1971 to 2010, we observe a negative relationship between decommodification and the age-standardized death rate. We then analyze three correlates of decommodification—income redistribution, labour market polarization and the reduction of labour market risk incidence—and find that only the latter two are associated with population health. Higher labour market polarization, measured by the share of market income allocated to the richest decile relative to the share of the poorest decile, is associated with a higher death rate. A new measure of risk reduction, the degree to which the welfare state reduces the prevalence of large income losses, is also associated with lower death rates, especially for men. Welfare state decommodification thus contributes to population health directly, and indirectly, via the attenuation of labour market polarization and the mitigation of labour market risks.