TAILIEUCHUNG - Economic Development and the Escape from High Mortality

The health benefits of prevention are intuitive—it is wiser to prevent a disease than to face its consequences at a more advanced stage—but for many years policymakers, politicians, and professionals have also advanced the economic argument that prevention saves money. Enthusiasm for prevention has become prominent in health care reform discussions in Congress and was a theme during the 2008 presidential election. Prevention is seen as the touchstone of a redesigned system focused on improving health outcomes. 7 Prevention advocates have emphasized that it will save money, arguing that prevention is not only good for health but also. | World Development Vol. 35 No. 4 pp. 543-568 2007 jRsiS 2007 Elsevier Ltd. All rights reserved 0305-750X - see front matter ELSEVIER locate worlddev doi Economic Development and the Escape from High Mortality JAVIER A. BIRCHENALL University of California Santa Barbara CA USA Summary. This paper studies the characteristic features of the escape from high mortality as recorded from the historical experience of Northwestern Europe and from the current experience of less developed countries. The paper documents stylized facts of mortality change and measures the contribution of economic development represented by income per capita to the mortality decline during the second half of the 20th century. The paper argues that improvements in economic conditions since the 18th century are an important factor behind the decline in death rates in developed countries and in the subsequent reduction of death rates in less developed countries. We show that economic development lowers mortality through differential effects in infectious disease mortality and that quantitatively income growth is able to account for between one-third and one-half of the recent mortality decline. 2007 Elsevier Ltd. All rights reserved. JEL classification I12 O11 O33 Key words mortality economic development developed and less developed countries 1. INTRODUCTION Death is inevitable and irreversible but the last three centuries have seen remarkable progress in the reduction of human mortality. The mortality of pre-modern populations varied considerably but a simple comparison typically finds that the average life expectancy at birth has roughly doubled during the last three centuries. The decline in death rates has proceeded at non-uniform rates but it has affected all geographic areas and all demographic groups in the world. Today even the countries with the highest death rates such as those in sub-Saharan Africa are above the historical mean despite the .

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