Monday, January 15, 2018

Health and Productivity

Not long ago, the US Embassy in Kenya sent out a notification of a cholera outbreak in the country.  There have been 3000 cases with sixty deaths so far.   It made me think of a research paper that I wrote for one of my classes on the correlation between health and productivity.  We all know of organizations who do great work in addressing health issues around the world.  Two that come to mind immediately for me are Doctors Without Borders (MSF) and the Mercy Ships.

While we laud their work, there may be another motivation for us to address health, than simply for the sake of health.  There is a great deal of evidence that health and productivity, or the economic development of a nation, may be linked.  There is also a great deal of evidence that health and per capita income are linked.  Therefore, if the health of a person is increased, their income may be increased, which may lead to the income of an entire nation to be increased.  This is part of the reason why the Millennium Development Goals focused on health, and why the Sustainable Development Goals that I mentioned last week continue to focus on health.

As it relates to physical health, there have been great strides made around the world in the last fifty years.  According to the World Health Organization:
  •  In 1950, 280 of every 1000 children died before their fifth birthday; by 2002, that number has fallen to 120 per 1000 births in low-income countries, 37 in middle-income countries, and 7 in high income countries.   
  • Some important diseases have been largely controlled, eradicated or nearly eliminated, such as smallpox, rubella, and polio. 
  • There are 17,000 fewer children dying every day in 2012 than in 1990, however nearly 18,000 children still died every day in 2012.  There amounts to the loss of over six million children each year due to preventable diseases. 
  • Many children who survive suffer from malnutrition, malaria, and water borne diseases.   The efficiency cost of hunger is significant, as those who suffer feel weak, lacking in energy, are more susceptible to infection and other illnesses, and may have physical and cognitive impairment due to nutrient deficiencies.   
  • One study suggests that the elimination of undernourishment in Sub-Saharan Africa would raise the economic growth rate from 0.34-4.63 percentage points.  Another study showed that an increase in calories intake by employees increased productivity in a construction firm in Kenya and agricultural productivity in Sierra Leone.  Current evidence indicates that undernutrition is the underlying cause of death in an estimated 45% of all deaths among children under the age of five. Malnutrition or undernourishment can be tied to income.    
  • Malaria is another significant disease that affects the supply of labor due to the high death rate and the productivity of laborers to the point that economists suggest that the growth rate of a country may decrease by 0.23-1.3%.  
  • Malaria can be contracted almost regardless of income.  According to the World Health Organization, 3.2 billion people are at risk for contracting malaria; in 2013, 198 million cases occurred, and the disease killed approximately 584,000 people.   On average, malaria kills a child every minute.
  •  Tuberculosis is one of the world’s biggest infectious killers with an estimated nine million new cases in 2013, and an estimated 1.5 million deaths. 
  • Waterborne diseases kill two million children annually per year, and include such diseases as cholera, typhoid, dysentery, and work infections, to name just a few.   Adults more typically survive these diseases but their productivity is impaired while sick.   Water borne diseases can very much be tied to income.
  • Child labor continues to be a widespread problem as well, which often results in physical stunting of children, as well as exposure to cruel and exploitative working conditions.   The International Labor Office (ILO) estimates that there are around 120 million children between the ages of 5 and 14 who are working fulltime, with another 130 million children working half time.These numbers do not include those children who work at home for their parents or guardians.  However simply banning child labor will not improve the situation, as many of the children survive from the meager wages that are earned.   Rather, raising the per capita income may result in a decrease in child labor and an increase in health.
There have been significant improvements in health however it is apparent that there remains a great deal of work to be done.   The impact of bad health on the human capital within a country is significant and can significantly impact a person’s personal income, a country’s productivity, and the national GDP.

This chart shows the correlation between health and income, and the effect on life, very well.

Development is sometimes referred to as a "headless heart" when it is done only based on
compassion without looking at the big picture.  This reminder of the importance of health on productivity, which then leads to the health of nations and its citizens, reminds us that people are the solution when given a fair and equal opportunity, such as health.

[Side note:  The other interesting thing that I read recently is that they continue to measure happiness of citizens in various nations, and have found that happiness levels off after people reach a certain income level (and it's not that high of an income level either).  This diplomat then said that countries make a mistake when they continue to make it their singular goal to see that their country continue to grow in wealth year after year...maybe the focus needs to be somewhere else...something to think about.]