"Wealthier is healthier." This characteristically pithy observation by Lant Pritchett and Lawrence H. Summers (1993) summarizes one of the most firmly-established findings about population health. Health is closely related to social class. This "health gradient" shows up in all the developed democracies. On a wide variety of measures, people of higher socioeconomic status tend to be healthier than those on the lower rungs of the socioeconomic ladder.
Contemporary approaches to varieties to capitalism are often criticized for neglecting issues of institutional change. This paper develops an approach to institutional change more extended than the one provided in Hall and Soskice(in Varieties of Capitalism: The Institutional Foundations of Comparative Advantage, Oxford, Oxford University Press, 2001) but congruent with its varieties-ofcapitalism perspective. It begins by outlining an approach to institutional stability, which suggests that the persistence of institutions depends not only on their aggregate welfare effects but also on the distributive benefits that they provide to the underlying social or political coalitions; and not only on the Paretooptimal quality of such equilibria but also on continuous processes of mobilization through which the actors test the limits of the existing institutions. It then develops an analysis of institutional change that emphasizes the ways in which defection, reinterpretation and reform emerge out of such contestation and assesses the accuracy of this account against recent developments in the political economies of Europe. The paper concludes by outlining the implications of this perspective for contemporary analyses of liberalization in the political economy.