Living and studying all over East Asia, some of Hannah Kim’s most favorite activities were to meet and talk to diverse people from different backgrounds. Those conversations sparked her interest in how public opinion and perceptions of democracy differ across societies — a question that turned into the focus of her doctoral dissertation, which she completed last year at the University of California, Irvine.

Image

We sat down with Hannah to talk about her current work and her plans for future projects.

Q: As you’ve been here at APARC researching your book, what kinds of relationships have you found between the middle classes of East Asia and their perceptions of a democratic society?

Middle-class groups in many East Asian countries are significantly different than those in other regions because they are newer and smaller. They also tend to be much more dependent on the state, and this state dependency has led to fundamentally different views of democracy than we see in other places.

Modernization theory — which is one of the most prominent theories in comparative politics — contends that higher levels of economic growth lead to a rise of a middle class. This middle class then becomes a driving force for democracy. In East Asian countries, however, state-led economic growth played a central role in the creation and development of middle-class groups, which fostered a dependent and mutually supportive relationship between middle-class groups and the state. This suggests that middle-class groups may prefer a stronger role of the state and be less likely to support liberal democracy relative to other groups.

Q: What research findings surprised you about the relationship between the middle class and democracy?

There have been a number of unexpected results. For one, middle-class East Asians are more likely to support good governance ahead of freedom and liberty, which is often reversed among middle-class groups in Western democracies. I’ve found that many East Asian middle-class citizens view democracy more illiberally and prefer a political system that has a mix of democratic and autocratic properties — a hybrid regime — rather than a liberal democracy.

For example, the most recent wave of the World Values Survey (2010-14) shows that 62% of Taiwanese respondents, 31% of Chinese respondents, 29% of Japanese respondents, and 49% of South Korean respondents stated that it is “Very good” or “Fairly good” to have a strong leader who does not have to bother with parliament and elections. This indicates a culture of implicit support for an authoritarian-like leader. Recent studies also show that there is a negative correlation between the middle class and support for democracy in China.

Q: You have also been doing work that looks at democratization and gender in East Asia. How do gender, gender roles, and traditional culture impact the progress and perception of democratization?

Even though there are three full-fledged democracies in East Asia – namely, Japan, South Korea, and Taiwan – their citizens’ views on gender equality remain far from liberal. A majority of respondents to surveys in those democracies support the ideas that men should have more employment and education opportunities than women, and that men make better political and business leaders than women. This may be in part due to the historically patriarchal culture that continues to legitimize these views. However, in my study, I suggest that culturally democratic citizens are more likely to break away from these traditional patriarchal norms and challenge gendered practices within these societies. Increasing democratic citizenship, therefore, may enhance support for gender equality and other liberal values.

Q: What pressing challenges do you see facing Asia’s democratic societies?

The last ten years have been described as a decade of decline for liberal democracies worldwide and public opinion data further shows that support for democracy is rapidly declining. East Asian democracies, many of which democratized during the so-called second and third waves of that trend in the late twentieth century, are no exception to this democratic recession. While there are many institutional limitations, the biggest challenge for East Asian democracies may come from authoritarian legacies that encourage middle-class citizens to support traditional values that often go against liberal democracy. While East Asian democracies may not necessarily evolve towards autocracy, it may be a while before the middle class and the general public in East Asian countries fully support liberal democratic values and help democracies overcome this democratic recession.

Q: What’s next on your research agenda?

After my fellowship with APARC concludes, I will be moving to Omaha, Nebraska, where I’ll be working as an assistant professor of political science at the University of Nebraska. I’m scheduled to teach Asian politics there this coming fall, which I am really looking forward to. My immediate research goal is to continue working on my book, but I would also like to start pursuing research on gender and political behavior in South Korea.

Using a dynamic microsimulation model, a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston, shows that there are differentially positive health gains of smoking reduction among subgroups of smokers in South Korea, Singapore, and the United States.

Tobacco use is responsible for the death of approximately eight million people worldwide, estimates the World Health Organization, and countries are increasingly making tobacco control a priority. Indeed the relationship between smoking and the burden of chronic diseases such as cancer, lung disease, and heart disease, and, in turn, premature mortality, is well documented. Yet little is known about the health effects of smoking interventions among subgroups of smokers.

Do interventions targeted at heavy smokers relative to light smokers lead to disproportionately larger improvements in life expectancy and prevalence of chronic diseases? And how do these effects vary across populations? In today’s rapidly aging world, it is crucial to understand the potential health gains resulting from interventions to reduce smoking, a leading preventable risk factor for healthy aging.

That’s why a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston as well as Stanford Health Policy faculty member Jay Bhattacharya, set out to examine the health effects of smoking reduction. To do so, the team simulated an elimination of smoking among subgroups of smokers in South Korea, Singapore, and the United States.

[To receive more stories like this directly to your inbox subscribe to our newsletters.]

The team’s findings, discussed in a new paper published by the journal Health Economics, show that smoking reduction can achieve significant improvements in lifetime health as measured by survival while also reducing the prevalence of major chronic diseases, though the effects are heterogeneous. Whereas interventions in both subgroups and in all three countries led to an increased life expectancy and decreased prevalence of chronic diseases, the life-extension benefits were greatest – 2.5 to 3.7 years – for those who would otherwise have been heavy smokers, compared with gains of 0.2 to 1.5 years among light smokers.

The team developed a dynamic microsimulation model to estimate the health gains of reducing smoking among heavy smokers and light smokers. Microsimulation models are powerful tools for assessing the value of health promotion: they model individual health trajectories while accounting for competing risks, thus providing valuable information about the impact of interventions and how they may interact with the changing demographics and socioeconomic profile of a population to determine future health. The team’s study applied microsimulation models tailored to the demographic and epidemiological context in the three countries, then compared the gains in survival and reduction in chronic disease prevalence from a given reduction in smoking and how these impacts vary depending on initial smoking intensity.

The team’s findings indicate that there are differentially positive health effects from smoking reduction. The life‐year gain among heavy smokers quitting well exceeds that of light smokers quitting in each country, but the magnitudes differ substantially: 11.2 times for South Korea, 6.8 times for Singapore, and 1.7 times for the United States. The lower life expectancy among Americans is related to the greater extent in which they suffer from risk factors, such as obesity, relative to the Asian counterparts in the study.

The findings illustrate how smoking interventions may have significant economic and social benefits, especially for life extension, that vary across countries. They are particularly important for aging societies that are concerned about the sustainability of their health insurance systems in the face of increasing burden of chronic disease.