CHRISTOPHER DYE
Is wealth good for your health?
CHRISTOPHER DYE
Is wealth good for your health?
CHRISTOPHER DYE
Is wealth good for your health?
CHRISTOPHER DYE
Is wealth good for your health?
CHRISTOPHER DYE
Is wealth good for your health?
CHRISTOPHER DYE
Is wealth good for your health?
Employment
Education
£$¥
Technology
Environment
CHRISTOPHER DYE
Is wealth good for your health?
Revolutions in England since 1500:
industrial, health, economic
25000
80
20000
70
60
15000
50
10000
40
5000
30
20
1500
0
1600
1700
1800
1900
2000
GDP/capita (1990 I$)
Life expectancy at birth (yr)
90
The Preston
curve (1975)
Samuel H Preston
University of
Pennsylvania
The Millennium Preston Curve
Spain
80
France
Italy
Japan
Mexico
China
UK
Germany
USA
Korea
life expectancy, 2000
70
Brazil
India
Argentina
Russia
Indonesia
60
Pakistan
Bangladesh
Gabon
50
Equatorial Guinea
Nigeria
Namibia
40
South Africa
Botswana
0
10,000
20,000
30,000
gdp per capita, 2000, current PPP $
Source: Deaton, 2006
40,000
HANS ROSLING
Karolinska Institut, Stockholm
GAPMINDER FOUNDATION
"Bring me my sword!"
"The grievous truth is that… the bottom billion
will not—and cannot—be freed from poverty in
our lifetimes."
Wealth is
good for
health?
"Wealthier is healthier"
Pritchett & Summers 1993
58 countries with GDP/capita <$6000, 1960-85
5% increase in income
1% reduction in infant
mortality
Africa: +1.5% growth in 1980s saves 0.5m lives in 1990
Public spending on health
$$ x 1000 = U5M/10
Under 5 mortality
1000
100
10
1
1
10
100
1000
Total $$ spent on health per person
10000
Health is
good for
wealth?
WHO Commission on Macroeconomics
and Health
REDUCES ABSENTEEISM BY
ONE QUARTER IN KENYA
treatment
periods
School participation
(comparative)
0.12
0.08
0.04
0
-0.04
-0.08
0
5
10
15
Months of treatment
20
25
"Demographic dividends" and "economic miracles"
From health to wealth?
Share population of working age
0.75
education
economics
governance
public health
family planning
0.7
East Asia
0.65
One third economic
growth from
"demographic gift"
0.6
0.55
Sub-Saharan Africa
0.5
1950
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
Africa awaits the economic miracle
60
% living on <$1 per day
1990
2008
2015
50
40
30
20
10
0
East Asia
Sub-Saharan Africa
Ireland, the Celtic tiger
…growing workforce
Falling fertility...
Working/non-working population
Children/woman
4.5
Ireland
3.5
UK
2.5
1.5
1960
1980
2000
Asia
2.2
UK
1.7
Ireland
1.2
1950
2000
2050
Growth GDP/capita (%/yr)
And the Irish get wealthier...
7
6
5
4
3
2
1
0
-1
-2
-3
1950
1960
1970
1980
1990
HIV/AIDS cuts the productivity of tea pickers
in Kenya
46
44
HIV-
40
38
36
34
HIV+
32
30
3
2
1
Years before death
0
Kgs plucked daily
42
"To your health"
More than a toast to economists
D Malakoff (Science 2000)
Price tag on productivity in USA, 1970-90
A year of life gained for 35-44 year-olds
worth:
Men
$170,000
Women
$120,000
Fiscal health: saving for retirement
Wealth is bad
for health?
USA: wealthier but not healthier
GDP #7 Life expectancy #42
17
46
16
44
15
42
40
14
38
13
36
12
34
11
32
30
1986
10
1991
1996
2001
2006
Percent uninsured
Number uninsured (m)
48
Health in a sweeter world
Health in a sweeter world
Kcal sugar/person/day
500
400
1962
2000
300
200
100
0
poorest 1
2
3
4
GDP/person -- country groups
richest 5
S w Ja
itz pa
er n
la
nd
Ita
Fr ly
an
A ce
us
Sw tria
ed
H en
ol
D lan
en d
m
a
Fi r k
nl
an
Ic d
el
an
Sp d
ai
C n
ze
C ch
an
ad
a
A N
us Z
tr
al
ia
U
K
U
SA
Percent obese
Rising obesity in rich countries
serial surveys OECD, 1980-2002
35
30
25
20
15
10
5
0
Falling
wealth,
failing
health?
Cycles: virtuous vicious
sickness
health
poverty
wealth
Infant mortality
One million “excess” deaths
in developing world since 1980 due to
contractions in economies
One million “excess” deaths
in developing world since 1980 due to
contractions in economies
Children die when GDP falls
Relative risks higher for vulnerable
children born:
To low-education mothers
Young/old mothers
In rural areas
If boys
+68%
+23%
+72%
+11%
Wealth is mostly good for health,
but…
Microeconomics
• Money buys health, and 1o health is cheap
• Money buys health directly (medicines) and indirectly
(education for prevention and cure)
• Health underpins prosperity -- individual, family, business
Macroeconomics
• Health is linked to wealth across countries and
generations…
• The cause? Social? Cultural? Educational?
Technological? All? A minimum set?
Buying health
• Microeconomic argument often enough?