Health Improvements and Health Inequality during the Last 40 Years

Abstract

The debate on the pace of improvement and convergence in levels of wellbeing between and within countries has acquired a particular relevance during the recent decades of economic liberalization and globalization. Though trends in wellbeing can be, and indeed are, affected by non-economic and non-policy factors, sustained improvements and convergence over time in wellbeing indicators across and within countries could be interpreted as an indication of the success of the liberal approach to policy making (Dollar 2001). In turn, slow progress and growing divergence might reinforce the claims of the critics who argue that globalization is inefficient and that — both globally and within each nation — it mainly benefits the upper income groups. The attention received by this debate in policy circles has substantially soared with the adoption of the Millennium Development Goals (MDGs) that have set clear targets for many indicators of wellbeing, including health wellbeing indicators such as infant mortality rate (IMR) and under-five mortality rate (U5MR). The explicit inclusion of health indicators among the MDGs is essential for various reasons. Health is a fundamental dimension of human wellbeing, good health is instrumental for improving other dimensions of wellbeing, and intertemporal and inter-country comparisons based on health wellbeing indicators are less fraught with statistical problems than comparisons effected, for instance, in the monetary space. For all these reasons, this chapter focuses on changes in the level and distribution of health wellbeing.