Comment on “What's Not Converging? East Asia's Relative Performance in Income, Health, and Education”

Abstract

While health conditions and educational attainment have shown clear signs of worldwide convergence over the period 1960–2000, no such evidence has been found for per capita gross domestic product (GDP) during the same period.1 This is the surprising finding discovered by Kenny's (2008) careful examination of various global data. Shocking as it may be, however, the pertinent explanatory factors at work behind the scenes are easy to comprehend. First of all, the state of health and educational attainment reflects the accumulation of socioeconomic circumstances in the past (a stock concept) rather than the level of income in a single-year (a flow concept). Second, and more important, individually targeted medical-care measures have gradually, but consistently, spread to relatively poor, developing nations, pushing up their infant survival rates, while international income gaps have not been reduced noticeably. Health variables (including life expectancy) are directly related to personal/family living conditions, whereas income generation is the result of a large number of interrelated and highly complex factors. Moreover, it would be relatively inexpensive, socially speaking, to introduce preventive measures against sickness for individuals at the infant stage of their life, compared with the progressively expensive healthcare and medical treatments for adults and senior citizens, who comprise increasingly larger portions of the populations in richer, industrialized countries. The marginal effective rate of improvement in life expectancy slows down as a nation's real income level improves and the mean age of its population goes up: a process that takes place irrespective of the convergence or nonconvergence of real GDP per capita among nations. This discovery has at least two significant implications. First, relatively inexpensive healthcare measures, including education relating to preventing sickness, are highly effective in improving the survival rates of infants and children. In this respect, the international cooperative activities of nonprofit organizations must have played a significant role in improving the average life expectancy at birth. It would also be advisable for developing nations not to hastily abolish their indigenous, premodern systems of health care. Second, at least to the extent that income and life expectancy are only loosely associated, if at all, one comes to realization that the concept of GDP per capita has been virtually stripped of its straightforward welfare implications which may have existed half a century ago.