Why health policies should be transnational: A case for East Asia Pacific countries

Preshit Nemdas Ambade, Chinmayee Katragadda, Diana Sun, J. Lyle Bootman, Ivo Abraham

Research output: Contribution to journalArticlepeer-review


This paper argues that health policies should transcend national boundaries yet should not reach the supranational level. Along with multinational global health efforts, such cross-national health policies are essential to leverage joint efforts by countries learning from their peers that experience similar health system challenges. In our analysis, we used World Bank Health, Nutrition, and Population (HNP) data from 1995 to 2014 for East Asia Pacific (EAP) countries to explore health system comparability across member nations. We applied a hierarchical cluster analysis using Ward's method and a squared Euclidean distance approach to classify 24 EAP countries into four relatively stable clusters based on their (dis)similarities over nine selected health expenditure and health system performance related indicators. One-way analysis of variance (ANOVA) was used to assess the discreteness of the formed clusters. Each cluster had unique characteristics based on the included indicators and health system performance of the member countries. We present transnational health policy recommendations for the EAP region based on both our use of robust methodology and the resulting comparative clusters.

Original languageEnglish (US)
Pages (from-to)101-125
Number of pages25
JournalInternational Journal of Risk and Safety in Medicine
Issue number2
StatePublished - Jan 1 2019


  • EAP
  • East Asia Pacific countries
  • health system research
  • hierarchical cluster analysis
  • transnational health policies
  • world bank health nutrition and population statistics database

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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