People who live in socialist countries enjoy a higher level of health, education and overall physical quality of life than do residents of capitalist countries with similar economic development, according to a study co-authored by UC Irvine and and Cal State Long Beach professors.

Socialist countries out-performed capitalist countries in nearly every area, according to the study by Howard Waitzkin, UCI professor of medicine and social sciences, and Shirley Cereseto, professor emeritus of sociology at Cal State Long Beach. The study, which looked at infant and child death rates, life expectancy, the availability of doctors and nurses, nutrition, literacy and other educational factors, is in the current issue of the American Journal of Public Health.

The study did not include the United States or other high-income capitalist countries in the comparisons because there were no equivalent socialist countries, the researchers said.

While the quality of life appeared to increase with the wealth of the country, socialist or capitalist, the differences between the two categories were most “profound” in comparing the low-income countries, according to the report.


Public health and education provided in the low-income socialist system “seem to overcome some of the grueling deprivations of poverty,” according to the report. While wealthier capitalist countries have “enjoyed the fruits of public health and educational improvements,” the poorer capitalist countries provide inadequate health and educational services, the report said.

“Our findings indicate that countries with socialist political-economic systems can make great strides toward meeting basic human needs, even without extensive economic resources,” Waitzkin and Cereseto wrote. “When much of the world’s population suffers from disease, early death, malnutrition and illiteracy, these observations take on a meaning that goes beyond cold statistics.”

The only area in which the capitalist countries out-performed the socialist nations was in numbers enrolled in higher education.

In interviews Friday, Waitzkin and Cereseto acknowledged that socialist countries have problems in other areas.


“But they don’t have starvation,” said Cereseto, a retired professor who lives in Anaheim.

The socialist countries demonstrate that “even under conditions of poverty, a national coherent plan to deal with public health and education can make a marked impact,” Waitzkin said.

Using data supplied by the World Bank, the researchers classified the 13 socialist and 100 capitalist countries into income categories. Thirty-three nations--including India, Haiti, Pakistan and many African nations--made up the list of low-income capitalist countries, while China was listed as the sole low-income socialist country. Lower-middle-income capitalist countries numbered 27, including El Salvador, the Philippines, Peru, South Korea and Lebanon, while their socialist counterparts were composed of Cuba, Mongolia, North Korea and Albania. Upper-middle-income capitalist countries included Mexico, Ireland, Spain, Italy, Iran, Iraq and 13 others; the socialist counterparts were the USSR and seven other Eastern European nations.

The study also listed 15 high-income capitalist countries--including the United States, United Kingdom, Switzerland and Japan--and five high-income oil-exporting nations, but there were no socialist countries for comparison in either category.


Ten recent “postrevolutionary” countries were listed, and the researchers concluded they scored similarly to low-income capitalist countries on “physical quality of life.”

Lower Infant Mortality

Socialist countries in each level of development had infant mortality and child death rates two to three times lower than the corresponding capitalist countries, according to the study. Socialist countries consistently showed higher numbers of health professionals per capita than capitalist countries at equivalent economic levels.

Waitzkin said he can only speculate as to why the socialist countries fared better, but believes that socialist countries consider health care “a basic human right. It is an issue of basic human entitlement,” he said. They institute public health programs, immunizations, prenatal and perinatal care, provide proper sanitation and assure adequate nutrition, he said.


“Their priorities are in that direction,” Cereseto said. “The first thing a country does when it becomes socialist is improve the health care and education and feed the people. . . . There are other things they don’t do well, but this is their goal, to feed their people and get them health care and education.”

‘Do Atrociously’

The low-income capitalist countries “do atrociously” in those areas, Cereseto said. Even in the middle-income capitalist nations, there are huge gaps in the quality of life for the haves and have-nots, Waitzkin said.

“Finding doctors and affording health care, all you have to do is go to Mexico or Africa to see this problem,” he said. “There is a small population of very wealthy who are able to buy medical care but the rest do not have access to preventive or curative care, or basic things like sanitation and proper nutrition,” Waitzkin said.


Capitalist countries can learn from the study, the researchers said.

“All the (capitalist) countries except the U.S. and South Africa guarantee health care as a right and provide some combination of health insurance or health service,” Waitzkin said. “Here in Orange County, we have an entire segment of the population with no access to health care,” he said, referring to illegal aliens and other indigents who do not qualify for public medical services.

More Uniform Care

One public health observer, who asked not to be named because he had not fully reviewed the study, agreed that socialist countries such as Cuba and North Korea tend to provide more uniform health and education services, while they suffer in production and wealth. But the observer questioned whether the study might be skewed by classifying the Soviet Union as upper-middle-income, because the country is more developed than many of the capitalist nations in the same category.


Waitzkin and Cereseto foresee that their study will produce controversy, but said there is a dearth of hard data comparing socialism to capitalism.

“One of the great problems in this country is assumptions made about capitalism and socialism are rhetorical and not based on evidence,” Waitzkin said. “We hope to stimulate more data comparing, to move away from the rhetoric.”

Said Cereseto: “I know some don’t like to hear that the socialist countries do anything good. And there are a lot of bad things. But to print only the bad things and avoid the good things puts into question our freedom of knowledge.”