Countries that are wealthy, have less income inequality, and whose citizens have the highest educational levels are the most likely to develop universal health care systems, according to new research from Harvard School of Public Health (HSPH). The study also found that countries run by dictators or those with high levels of ethnic fractionalization are less likely than others to implement universal health care.

The new findings are part of a comprehensive analysis by first author Andrea Feigl, a doctoral candidate in the HSPH Department of Global Health and Population, and senior author Eric Ding, research scientist in the HSPH Department of Nutrition. As part of their research, Feigl and Ding developed a standardized index for assessing universal health care coverage, and then calculated the likelihood that a particular country will successfully develop and achieve universal health care over time.

The study appeared online Aug. 1 in Health Policy. Read the abstract.

“This new index and analysis can boost understanding of the economic, social, and political drivers of universal health care,” said Feigl. “It could be particularly useful for transitioning countries as they seek to expand health care coverage for their citizens.”

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