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Brown EC 151 - Chapter 10 – Health and Nutrition

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Chapter 10 – Health and Nutrition, page 1 of 5• health and economic growth:• life expectancy, a measure of health human capital, is strongly correlated witheconomic growth; this could be because healthy workers are more productive (forexample, they are able to stay in the labor force for more years and the return to theireducation is higher) and because a higher growth rate enables people to spend more onhealth – there is a reciprocal relationship between health and development• although health and productivity are correlated on a cross-country level, it is difficultto establish a correlation on an individual level; health economists have tried to measurethe change in productivity of farmers after curing them of certain diseases or improvingtheir nutrition but have not been able to clearly establish a correlation betweenhealth/nutrition and productivity; there are complications to these studies, such asmeasuring nutrition, etc.• health is not only of interest because it can aid growth and development, but because itis a good in its own right and because it is a measure of well-being• from about 1950 to 1970 in China the life expectancy increased by about 20 yearswithout an increase in per capita income, but people did not feel they were better offbecause most were living longer in poverty – this brings up the question of how tomeasure life quality (which is only partially a function of health)• nutrition and the household:• studies have found that food programs for children do not improve their nutritionbecause parents feed them less at home; if there is insufficient food in a household, it isrationed first to the primary breadwinners, usually males (it is common to findhouseholds with adequately fed males and chronically malnourished females andchildren); thus, if a child is fed more, the household decision maker, seeing that morefood is available to the household, will reduce the child’s food consumption at home;studies have looked at children’s test scores to determine if being fed at school improvesacademic performance (although academic performance might not be related tonutrition)• economists have done detailed studies to measure household nutrition and havedeveloped models of intrahousehold bargaining power (addressing what determineswhich household members get the limited food that’s available)• life expectancy:• life expectancy is the mean expected age an individual can expect to live to based onthe current age distribution and death rates at different ages; life expectancy can increasethroughout a person’s lifetime if healthcare improves• page 347, figure 10-1 – life expectancy over time for several countries:Chapter 10 – Health and Nutrition, page 2 of 5life expectancy England, Wales, Sweden, US Latin America India40201850 1890 1990from 1850 to 1990, the life expectancy in all developing countries increased and the gapbetween developing and developed countries narrowed; in contrast, the income gapbetween developing and developed countries has grown over timethe improvement in life expectancy (also a measure of healthcare) is one of the successesof economic development• page 352, figure 10-2 – life expectancy and per capita income:life expectancy 1960s 1930sper capita incomethis figure shows that life expectancy increases as per capita income of a countryincreasesas income per capita grows at low levels of per capita income, life expectancy increasessharply; at higher levels of per capita income, life expectancy increases with per capitaincome less rapidlyin the 1960s, changes in medical technology “flattened” the curve and shifted it up at alllevels of per capita income; at given per capita incomes, countries were able to achievebetter health outcomes in the 1960s than they could in the 1930s which suggests thathealth outcomes are more responsive to general development than incomeChapter 10 – Health and Nutrition, page 3 of 5curative care is expensive, but has little impact on average life expectancy because it ismost commonly used for diseases that occur late in life, which adds few years to therecipient’s life; preventative medicine can prolong life for many people at low cost, andthere is little difference in affordability of preventative medicine between middle- andhigh-income countries (although it can be expensive for poor countries)this could explain why per capita income does not impact life expectancy significantlybeyond a certain per capita income; convergence can be expected as countries moveright on the curve, because the biggest gains are in poor countries• life expectancy at different ages:page 348, table 10-2 – comparison of remaining life expectancies at different ages in adeveloped (good healthcare) and developing (poor healthcare) country:Newborn Age 1 Age 5 Age 15 Age 65Sweden 72.1 71.8 67.9 58.1 13.9Bangladesh 45.8 53.5 54.5 46.3 11.6Difference 26.3 18.3 13.5 11.8 2.3the years listed in the table are the expected remaining life expectancies of a male in therespective country at the respective age; for instance, a male aged 1 in Bangladesh willlive an additional 53.5 years on average to age 54.5a striking feature of the data is that a 5 year old in Bangladesh actually had more yearsahead of them (on average) than a newborn; this is due to very high infant and childmortality (those who survive are those likely to live much longer than the average of allthose born)a newborn in Sweden can expect to live to age 72.1 but a male aged 65 an expect to livean additional 13.9 years to age 78.9; this difference is not because medical technologyimproves over the lifetime of the individuals, since this data considers life-expectancy ata fixed point in time; the difference between the overall life expectancy of the newbornand 65 year old is because those who survive to age 65 are a healthier subset of thepopulation and have a lower chance of dying from illness and/or malnutritionthe gap in remaining life expectancy between Sweden and Bangladesh narrows with age– for example, it is 11.8 at age 15 but 2.3 at age 65; the difference in remaining lifeexpectancy decreases because most mortality in poor countries occurs at young ages, sothose who survive to older ages in Bangladesh are about as healthy as those in Sweden• preventative versus curative healthcare and urban bias:• countries have adopted different policies with respect to the distribution of the benefitsof public health


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