Secular Trends in Physiological Capital: Implications for Equity in Health Care

Over the past three centuries there has been a rapid accumulation of physiological capital in OECD countries. Enhanced physiological capital is tied to long-term reduction in environmental hazards and to the conquest of chronic malnutrition. Data on heights and birth weights suggests that physiological capital has become more equally distributed, thereby reducing socioeconomic disparities in the burden of disease. Implications for health care policy are: (1) enhanced physiological capital has done more to reduce inequities in health status than has wider access to health care; (2) the main contribution of more advanced medical treatment so far has been to retard depreciation in individuals' physiological capital; (3) prenatal and early childhood care and environmental issues are key for interventions aimed at enhancing physiological capital and at affecting its rate of depreciation; (4) lifestyle change is the most important issue affecting health equity in rich countries; and (5) greater access to clinical care should be promoted through aggressive outreach, since expanded insurance coverage by itself is inadequate.

Why China is Likely to Achieve its Growth Objectives

In 2002, the Chinese Communist Party announced a goal of quadrupling per capita income by the year 2020. Starting at income levels of the year 2000, this would require a growth rate of 7.2 percent per annum in per capita income or close to 8.0 percent in GDP. Such unresolved and emerging problems as growing income disparities, increasing pollution, pressures on infrastructure, the inefficiency of state owned enterprises, and political instability are often cited as reasons to doubt the attainability of the CCP%u2019s goal. However, China%u2019s progress in addressing fundamental constraints that might limit rapid economic growth augurs well for the success of its economic goals. Although there are disagreements about economic policy among top leaders, the continued transformation into a market economy and the promotion of increasing local autonomy in economic matters are not in doubt. In education, China has substantially increased the percentage of its workforce receiving a college education, and continuing growth in this investment in human capital could account for a large portion of the desired growth rate. In addition, the value of improvements in the quality of economic output unmeasured by GDP, such as advances in the quality of health care and education, could raise reported growth rates by as much as 60 percent. Finally, the government%u2019s increasing sensitivity to public opinion and issues of inequality and corruption, combined with improving living conditions, have resulted in a level of popular confidence in the government that makes political instability unlikely.

Simon S. Kuznets: April 30, 1901-July 9, 1985

This paper, prepared for the Biographical Memoirs of the National Academy of Sciences, presents an account of the scholarly career of Simon S. Kuznets. Among the issues considered are his contribution to the development of the empirical tradition in economics, his transformation of the field of national income accounting, his use of national income accounting during World War II to set production targets for both the military and civilian sectors of the economy, and to guide the implementation of those targets; his development of a theory of economic growth, his investigation of the interrelationship between economic growth and population growth, his contribution to methods of measurement in economics, and his legacy to the economics profession.

Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy

Prize Lecture to the memory of Alfred Nobel, December 9, 1993Economics History;

Reconsidering Expectations of Economic Growth After World War II from the Perspective of 2004

At the close of World War II, the future of economic development was the subject of wide-ranging debates. Historical experience has since shown that these forecasts were uniformly too pessimistic. Expectations for the American economy focused on the likelihood of secular stagnation, which continued to be debated throughout the post-war period. Concerns raised during the late 1960s and early 1970s about rapid population growth smothering the potential for economic growth in developing countries were contradicted when, during the mid- and late-1970s, fertility rates began to decline rapidly. Predictions that food production would not keep up with population growth have also been proven wrong: between 1961 and 2000, calories per capita worldwide have increased by 24 percent, despite a doubling of the global population. The high rates of economic growth in East and Southeast Asia were also unforeseen by economists. Copyright 2005, International Monetary Fund

Some Notes on the Scientific Methods of Simon Kuznets

This paper discusses the scientific methods that guided the economic research of Simon Kuznets, with particular stress on his approach to measurement and theory. The paper closes with the transcription of a brief autobiographical talk by Kuznets at a dinner in honor of his eightieth birthday.

Changes in the Physiology of Aging during the Twentieth Century

One way to demonstrate how remarkable changes in the process of aging have been is to compare health over the life cycles of 3 cohorts. For the first cohort, born between 1835 and 1845 (the Civil War cohort), life was short and disabilities were common even at young ages. Other factors contributing to lifelong poor health were widespread exposure to severely debilitating diseases and chronic malnutrition. Fewer of the World War II cohort, born between 1920 and 1930, died in infancy and most of the survivors have lived past age 60 without developing severe chronic diseases. Members of this cohort have experienced better health throughout their lives largely due to their lower exposure to environmental hazards before birth and throughout their infancy and early childhood. Members of the cohort born between 1980 and 1990 have a 50-50 chance of living to age 100. The average age at onset of disabilities has continued to rise, so members of this cohort can expect to remain healthy at later ages. Adopting a healthy life style early can help to prevent or postpone disability at older ages.

Capitalism and Democracy in 2040: Forecasts and Speculations

While the economies of the fifteen countries that were in the European Union (EU15) in 2000 will continue to grow from now until 2040, they will not be able to match the surges in growth that will occur in South and East Asia. In 2040, the Chinese economy will reach $123 trillion, or nearly three times the output of the entire globe in the year 2000, despite the influence of several potential political and economic constraints. India's economy will also continue to grow, although significant constraints (both political and economic) will keep it from reaching China's levels. The projected decline of the EU15's global share of GDP means that liberal Asian nations will be poised to take up the role of promoting liberal democracy across the globe.

Who Gets Health Care?

Around the world, as in the United States, concern is growing about who gets health care. Individuals from different socioeconomic backgrounds face distressingly different prospects of living a healthy life. Disparities in various measures of health between the privileged and the deprived still remain wide, despite the long-term tendency toward a healthier society. Some investigators believe the shift in the health care system in industrial countries from the principle of universal access to a more market-oriented system may be one cause of the growing disparities; rising income inequality is another potential culprit. Policy makers worldwide speak of more efficiently delivering essential' health care---but disagree on what counts as essential and on the optimal mix of private and government components of service. After reviewing the economic and epidemiological literature on disparities in health and health care systems, the question of how to define essential' health care is considered. The paper concludes with a discussion of the policy implications of the analysis.