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AIMS: The COVID-19 pandemic has led to a spate of studies showing a close connection between inequitable access to health care, welfare services and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question by asking whether more 'egalitarian' forms of democracy matter, given that they contain more equitable health-care access and societal infrastructure, such as social capital and trust. METHODS: We use standard regression techniques, including instrumental variables analysis addressing endogeneity on COVID-19 testing and deaths data as of the end of May and beginning of September. We use novel data from the Varieties of Democracy Project on health-system equity and egalitarian democracy. RESULTS: Our results suggest that more equitable access to health care increases testing rates and lowers the death rate from COVID-19. Broader egalitarian governance, measured as egalitarian democracy, however, shows the opposite effect. Thus, factors associated with health-care capacity to reach and treat matter more than broader societal factors associated with social capital and trust. The results are robust to alternative testing procedures, including instrumental variable technique for addressing potential endogeneity. CONCLUSIONS: Despite a great deal of public health focus on how equitable governance helps fight the adverse effects of so-called neoliberal pandemics, we find that broadly egalitarian factors have had the opposite effect on fighting COVID-19, especially when an equitable health system has been taken into account. Fighting disease, thus, might be more about the capacity of health systems rather than societal factors, such as trust in government and social capital.

Aims: The COVID-19 pandemic has led to a spate of studies showing a close connection between inequitable access to health care, welfare services and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question by asking whether more 'egalitarian' forms of democracy matter, given that they contain more equitable health-care access and societal infrastructure, such as social capital and trust. Methods: We use standard regression techniques, including instrumental variables analysis addressing endogeneity on COVID-19 testing and deaths data as of the end of May and beginning of September. We use novel data from the Varieties of Democracy Project on health-system equity and egalitarian democracy. Results: Our results suggest that more equitable access to health care increases testing rates and lowers the death rate from COVID-19. Broader egalitarian governance, measured as egalitarian democracy, however, shows the opposite effect. Thus, factors associated with health-care capacity to reach and treat matter more than broader societal factors associated with social capital and trust. The results are robust to alternative testing procedures, including instrumental variable technique for addressing potential endogeneity. Conclusions: Despite a great deal of public health focus on how equitable governance helps fight the adverse effects of so-called neoliberal pandemics, we find that broadly egalitarian factors have had the opposite effect on fighting COVID-19, especially when an equitable health system has been taken into account. Fighting disease, thus, might be more about the capacity of health systems rather than societal factors, such as trust in government and social capital.

Violent crime in Mexico occurs at a rate that dwarfs the human costs of most contemporary civil wars, and the drug cartels responsible for the violence exercise de facto control over significant geographical territories. In this respect, the Mexican "drug wars" resemble conflicts over the control of rich natural resources in Sub-Saharan Africa and elsewhere, blurring the distinction between "political" and "social" or "criminal" violence. In the civil war literature, a young age structure has been argued to provide inexpensive rebel labor and thus increase opportunities for a rebel group to wage war against a government. Similarly, relatively large groups of "idle" young men could arguably be a factor that reduces recruitment costs for criminal enterprises through the abundant supply of youth with low opportunity cost. Acknowledging organized crime around drug trafficking as a major cause of crime and violence in Mexico, we ask whether the availability of large young male cohorts, or male "youth bulges", low education and high youth unemployment ease the recruitment to these organizations and may contribute to explain variance in violent crime rates across Mexican states over time. Using panel data covering 32 states in Mexico during the 1997–2010 period, we find that, while a coarse measure of regional youth bulges is not associated with patterns of violent youth crime, high youth unemployment in low-education strata is, in particular in the context of large male youth bulges. These results remain robust against alternative data, sample size, estimation techniques and controls for potential endogeneity concerns.

The consequences of foreign direct investment (FDI) for human rights protection are poorly understood. We propose that the impact of FDI varies across industries. In particular, extractive firms in the oil and mining industries go where the resources are located and are bound to such investment, which creates a status quo bias among them when it comes to supporting repressive rulers ("location-bound effect"). The same is not true for nonextractive multinational corporations (MNCs) in manufacturing or services, which can, in comparison, exit problematic countries more easily. We also propose that strong democratic institutions can alleviate negative impacts of extractive FDI on human rights ("democratic safeguard effect"). Using U.S. FDI broken up into extractive and nonextractive industries in 157 host countries (1999–2015), we find support for these propositions.1 Extractive FDI is associated with more human rights abuse, but nonextractive FDI is associated with less abuse, after controlling for other factors, including concerns about endogeneity. We find also that the negative human rights impact of extractive FDI vanishes in countries where democratic institutions are stronger. Our results are robust to a range of alternative estimation techniques. ; acceptedVersion ; © 2020. This is the authors' accepted and refereed manuscript to the article. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

Aims: The COVID-19 pandemic has led to a spate of studies showing a close connection between inequitable access to health care, welfare services and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question by asking whether more 'egalitarian' forms of democracy matter, given that they contain more equitable health-care access and societal infrastructure, such as social capital and trust. Methods: We use standard regression techniques, including instrumental variables analysis addressing endogeneity on COVID-19 testing and deaths data as of the end of May and beginning of September. We use novel data from the Varieties of Democracy Project on health-system equity and egalitarian democracy. Results: Our results suggest that more equitable access to health care increases testing rates and lowers the death rate from COVID-19. Broader egalitarian governance, measured as egalitarian democracy, however, shows the opposite effect. Thus, factors associated with health-care capacity to reach and treat matter more than broader societal factors associated with social capital and trust. The results are robust to alternative testing procedures, including instrumental variable technique for addressing potential endogeneity. Conclusions: Despite a great deal of public health focus on how equitable governance helps fight the adverse effects of so-called neoliberal pandemics, we find that broadly egalitarian factors have had the opposite effect on fighting COVID-19, especially when an equitable health system has been taken into account. Fighting disease, thus, might be more about the capacity of health systems rather than societal factors, such as trust in government and social capital. ; publishedVersion ; http://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Scholars of public health typically focus on societal equity for explaining public health outcomes. Indeed, the COVID-19 pandemic has led to a spate of studies showing a tight connection between inequitable access to healthcare, welfare services, and adverse outcomes from the pandemic. Others have argued that democratic governments have generally failed relative to more autocratic ones, simply because autocrats can make the hard choices required for stemming the spread of viruses. We address this question a bit differently by asking whether more 'egalitarian' forms of democracy matter, given that they should contain more equitable healthcare access and societal infrastructure, such as social capital and trust, for achieving a broader collective good. Our results suggest that more equitable access to healthcare does indeed increase testing rates and lower the death rate. Broader egalitarian processes, measured as egalitarian democracy, however, show the opposite effects, suggesting that factors associated with healthcare capacity to reach and treat matter more than broader societal factors associated with egalitarian governance.

How has government healthcare spending prepared countries for tackling the COVID19 pandemic? Arguably, spending is the primary policy tool of governments in providing effective health. We argue that the effectiveness of spending in reducing COVID deaths is conditional on the existence of healthcare equity and lower political corruption, because the health sector is particularly susceptible to political spending. Our results, obtained using ordinary least squares (OLS) and two-stage least squares (2SLS) estimation, suggest that higher spending targeted at reducing inequitable access to health has reduced COVID deaths. Consistent with the findings of others, our results indirectly suggest that health spending is necessary, but not sufficient unless accompanied by building resilience against the spread of deadly disease. Equitable health systems ease the effects of COVID presumably because they allow states to reach and treat people. Spending aimed at increasing health system capacity by increasing access thus seems a sound strategy for fighting the spread of disease, ultimately benefiting us all.

China's renewed prominence is the most important development in international relations in the 21st century. Despite longstanding rhetoric of its own "peaceful rise", China is increasingly viewed as a long-term strategic competitor, especially in the United States. Foreign aid is one arena where this competition may be playing out. While Western foreign aid principles have emphasized coordination and harmonization, the rise of China as a development partner has raised the specter of a return to competitive foreign aid practices. Most notably, China's Belt and Road Initiative (BRI), has received a wary reception by those who view it primarily as a geostrategic effort, but our knowledge of responses to the BRI is often anecdotal and fragmentary. To remedy this, we test if the BRI is inducing a competitive foreign aid response by evaluating if countries involved in this initiative are more likely to receive US support for loan packages from the major, Western, multilateral development banks (MDBs). Using an instrumental variable approach, covering 7,850 project/loan packages in 10 MDBs from 162 countries during 2013–2018 period, we find that the United States was more likely to vote for MDB packages to countries that have signed on to the BRI, but predominantly when the actual amount of Chinese aid flowing to those countries is still low, suggesting the United States is competing for "hedging" countries.