Effect of Global Fertility and Cultural Transition on Population Health: A Test of Competing Perspectives

Abstract

In this study, a crucial test of competing perspectives on structural determinants of population health has been conducted using the latest available data. These competing perspectives include income inequality thesis on income inequality as an unfavorable condition for population health, world polity theory on the role of international nongovernmental organizations as a favorable condition for population health, and importantly, a newly-formulated demographic transition thesis on how demographic transition as re-conceptualized as global fertility and cultural transition in creating favorable conditions for promoting population health. A panel analysis using random effects modeling and cross-tabulation for 65 less-developed countries over the period 1990-2010 strongly confirms the robust impact of global fertility and cultural transition on all indicators and an index of favorable conditions for population health and subsequent outcomes of population health, even controlling for the favorable condition effect of international nongovernmental organizations and the unfavorable condition effect of income inequality. Along with the process of the demographic transition, the index of favorable conditions for population health can be further applied to population health efforts and effectiveness evaluation (PHEEE) for less developed countries to gauge and predict health-related outcomes. Theoretical, empirical, and policy implications are further discussed.