Abstract

Deliberative Democracy: An Emerging Determinant of Health and Well-Being?

Michael Polanyi and Karen M. Andres

Over the past decade, there has been growing concern in North America about falling rates of electoral participation and civic involvement. Likewise, many social scientists have turned their attention to identifying ways to increase citizen engagement in policy-making processes, a prerequisite for a well-functioning democracy. The concept of "deliberative democracy" - the governing of affairs by public deliberation of members - has become popular.

Concurrently, new research has emerged suggesting that human health and well-being in industrialized countries is shaped as much by the characteristics of social settings - e.g. communities, workplaces and homes - as it is by the provision of medical services. It is also becoming clear that the way in which social settings and institutions are governed affects our health and well-being. For example, at the community level, social capital - which reflects levels of community participation and decision-making capacity - has been related to various health outcomes. At the national level, democratic participation appears to be correlated with levels of social and economic equality, another key determinant of health.

Despite these apparent links between democratic processes and health, researchers have been slow to examine this relationship empirically. We present a conceptual framework suggesting that deliberative democratic processes may create health-enhancing conditions in three inter-related ways: first, by increasing citizen knowledge, citizenship, participation levels and sense of power; second, by increasing community-level engagement, capacity, and mutual support; and third, by leading to better informed, and more equitable and effective governance.

Based on this framework, we outline a research agenda aimed at exploring the relationship between deliberative democracy and health. Discussion will be initiated on ways to increase collaboration between health researchers and social policy analysts on deliberative democracy and related population health issues.

Bios

Michael Polanyi has an M.A. in Political Science (University of Toronto) and a PhD in Environmental Studies from York University. He has worked professionally in the areas of adult education, community development and health promotion, facilitating community-based research and action by low-income youth, families and injured workers. Polanyi was a researcher and scientist at the Institute for Work & Health from 1995-2002. He was a Lupina Fellow in the Comparative Program on Health and Society at the Munk Centre for International Studies, University of Toronto (2001-2002). He has recently become a Faculty Researcher at the Saskatchewan Population Health Research and Evaluation Unit (SPHERU) based at the University of Regina.

Karen M. Andres has a M.Sc. in Health Promotion (University of Alberta) and is currently a Ph.D student in the department of Women’s Studies at University of Regina. Professionally, she has worked as a registered nurse in critical care for over seven years, and community development and health promotion over the past two years. Her academic interests include female adolescent health, development of sexuality, as well as evaluation.

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