Data from: Association of rule of law and health outcomes: an ecological study

Objectives: To explore whether the rule of law is a foundational
determinant of health that underlies other socioeconomic, political and
cultural factors that have been associated with health outcomes. Setting:
Global project. Participants: Data set of 96 countries, comprising 91% of
the global population. Primary and secondary outcome measures: The
following health indicators, infant mortality rate, maternal mortality
rate, life expectancy, and cardiovascular disease and diabetes mortality
rate, were included to explore their association with the rule of law. We
used a novel Rule of Law Index, gathered from survey sources, in a
cross-sectional and ecological design. The Index is based on eight
subindices: (1) Constraints on Government Powers; (2) Absence of
Corruption; (3) Order and Security; (4) Fundamental Rights; (5) Open
Government; (6) Regulatory Enforcement, (7) Civil Justice; and (8)
Criminal Justice. Results: The rule of law showed an independent
association with infant mortality rate, maternal mortality rate, life
expectancy, and cardiovascular disease and diabetes mortality rate, after
adjusting for the countries’ level of per capita income, their
expenditures in health, their level of political and civil freedom, their
Gini measure of inequality and women's status (p<0.05). Rule
of law remained significant in all the multivariate models, and the
following adjustment for potential confounders remained robust for at
least one or more of the health outcomes across all eight subindices of
the rule of law. Findings show that the higher the country's level of
adherence to the rule of law, the better the health of the population.
Conclusions: It is necessary to start considering the country's
adherence to the rule of law as a foundational determinant of health.
Health advocates should consider the improvement of rule of law as a tool
to improve population health. Conversely, lack of progress in rule of law
may constitute a structural barrier to health improvement.