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See also: Inequality and mortality in the US. Dreze, J. and A. Sen (1989). Hunger and Public Action. Oxford,Clarendon Press. Rodgers
GB. (1979) Income and inequality |
Material inequality kills, action to cut inequality saves lives Material inequality cuts life expectancy. Reducing inequality can increase how long people live. The graph (below) suggests that there is an association between GDP/capita (horizontal axis) and life expectancy (vertical axis). Differences in GDP per person indicate inequality between nations. So this graph shows how people in poor countries have shorter lives than people in rich countries. In reality, inequality within each country will exacerbate these differences. Poor people in poor countries live even shorter lives than the average for their country. What causes may explain the association between average country income (GDP per person) and average life expectancy? Better availability of health care, higher personal incomes and better provision of water and sanitation, are all associated with higher GDP/capita. These factors could each provide a causal link between GDP/capita and life expectancy. But this is not the complete story. There is substantial variation around a line that best fits these points. At similar levels of GDP/capita, people in some countries live much longer than the norm and people in others live much less than the norm. China and Sri Lanka are in the first group, living longer than the norm. Brazil and South Africa, Saudi Arabia and Barbados, are in the second, with shorter lives than the norm. In general terms, levels of inequality within each nation and state provision of social security can explain the anomalies.  Low-income,
high well-being countries
Public
action, often but not exclusively by governments, can reduce material
inequalities. Examples of such action would include land redistribution,
health care provision for the poor, subsidized food provision, livelihood
support and progressive taxation. In the graph above, China and
Sri Lanka are examples where public action enabled high life expectancy
despite low GDP/capita. Other examples include Cuba, and the Indian
state of Kerala (Sen 1993; Dreze and Sen 1989: Ch.10).
High income inequality often results in lower life expectancy South Africa, Saudi Arabia and Brazil have high levels of income inequality, and governments that have been chronically unresponsive to the needs of the poor. These two deficiencies are often reflected in low life expectancy relative to the GDP/capita of the country. Lack of income in the hands of the poor means they are unable to purchase medical care and other basic needs. Lack of government action to facilitate provision of livelihoods, food, health care, and other needs, also lowers life expectancy among the poor. Dreze and Sen (1989: Chapter 10) provides a fuller exploration of how economic growth and public support interact to influence well-being. Why are gaps in human survival narrowing?Aside from the AIDS crisis in Africa (see life expectancy presentation), life expectancy is rising in the global South. There are two reasons why the North (industrialized)-South (developing) gap in life expectancy is narrowing, despite widening economic gaps. Firstly, primary and preventive health care, and education, are relatively cheap and require mostly labor. This means basic health services can be provided for less cost in economies where wages are low. Modest increases in national income can, therefore, support increased disease prevention, such as vaccination and clean water provision. Secondly, GDP/capita is rising in much of the global South, though not as fast as in the industrialized North. Links and references: The International Health Program at the University of Washington has excellent coverage on the link between income inequality and health: http://depts.washingto.edu/eqhlth/ See also: Inequality and mortality in the US. Dreze, J. and A. Sen (1989). Hunger and Public Action. Oxford, Clarendon Press. Rodgers GB. (1979) Income and inequality as determinants of mortality: an international cross-section analysis. Population Studies; 33: 343-51. Sen, A. (1993). "The Economics of Life and Death. Scientific American"(May): 40-47. |