Human Capital Health Research Articles

Food security in the context of climate change and bioenergy production in Tanzania: methods, tools and applications

A dramatic population growth is projected for the least developed countries of the world (United Nations 2013), which will also suffer disproportionally from ongoing and predicted climate disruptions (IPCC 2013). More frequently occurring extreme weather events have led to yield losses and decreasing cattle populations—aggravating an already precarious situation and leading to critical food shortages. Food security is a function of food availability, food accessibility, food stability and food utilisation (FAO 2002; Ziervogel and Ericksen 2010). Climate change and population growth are seen as key drivers of food insecurity severely affecting farming systems (Muller et al. 2011; Haberl et al. 2011, Strengers et al. 2010), as well as the global energy demand and therefore induced biofuel production (Von Braun 2007a), changing trade patterns through liberalisation and globalisation (Von Braun 2007b; Lotze-Campen et al. 2010), and the state of health of the population (10–20 % AIDS rate in East Africa). Cause– effect chains, in which food security is involved (droughts– diseases–health–human capital), are also drivers over large regions (Ziervogel and Ericksen 2010). Most of these drivers do not only lead to a productivity decline, but also often result in a degraded natural resource base and declining soil fertility (Graef et al. 2000). Rapidly changing framework conditions (Muller 2011) require a thorough understanding of integrated food systems and targeted incorporation of region-specific innovations. However, creating a sustainable road map for the future is a huge challenge for a variety of reasons. Mainly rainfed, subsistence-oriented smallholder farming systems are not only extremely vulnerable to a changing and unpredictable climate, but often also lack access to external inputs, institutional support and adaptive capacity. Moreover, food insecurity is often regarded as insufficient food availability which is only part of the picture. Instead of solely focussing on boosting crop yields, the highly complex state of vulnerability needs to be addressed encompassing economic and sociopolitical factors (Misselhorn 2004; Pretty et al. 2006). Also, increased bioenergy production has fuelled land use conflicts and lead to largescale deforestation due to the growing international demand for biofuels. Biomass is still the primary source of energy in developing countries—important for income, energy supply, poverty reduction and self-sufficiency of rural communities (Harvey and Pilgrim 2011; Mitchell 2011; Tilman et al. 2009). Effective climate change adaptation and food security intervention strategies need to pursue a holistic approach and an array of objectives: social and economic viability, soil health, minimum use of scarce water and fossil energy, affordable and low external inputs, improvement in infrastructure and market access, as well as conservation of natural resources and biodiversity. To achieve positive impacts and sustainable solutions, international research projects increasingly focus on integrated in-depth analysis of the food system itself and its core elements: (a) natural and human resources, (b) the use of Disclaimer The views expressed are purely those of the authors and may not in any circumstances be regarded as stating an official position of the European Commission.

Health Shocks and Human Capital Accumulation: The Case of Spanish Flu in Italian Regions

Percoco M. Health shocks and human capital accumulation: the case of Spanish flu in Italian regions, Regional Studies. The impact of health on economic development is a hotly debated issue in the economics literature, with most scholars supporting the idea that the diffusion of diseases is detrimental to development. In this context, pandemics are an important case study given their exogenous nature, which makes identification of the impact of diseases on development clearer than in other cases such as malaria or smallpox. This paper focuses on Spanish flu in Italy, one of the countries with the highest mortality rate due to the pandemic. By exploiting the regional variation in mortality and focusing on the hypothesis of the foetal origins of cognitive abilities, the long-run consequences of influenza exposure in terms of human capital accumulation are estimated. An average reduction of 0.3–0.4 years of schooling for the cohort born in 1918–20 is found. This result points to a small but persisting effect of health shocks on regional productivity through a variation in the rate of accumulation of human capital.

The Impact of Human Capital Development on Economic Growth in Ethiopia: Evidence from ARDL Approach to Co-Integration

The main objective of the study was to investigate the long run and short run impact of human capital on economic growth in Ethiopia (using real GDP per capita, as a proxy for economic growth) over the period 1974/75-2010/2011. The ARDL Approach to Co-integration and Error Correction Model are applied in order to investigate the long-run and short run impact of Human capital on Economic growth. The finding of the Bounds test shows that there is a stable long run relationship between real GDP per capita, education human capital, health human capital, labor force, gross capital formation, government expenditure and official development assistance. The estimated long run model revels that human capital in the form of health (proxied by the ratio of public expenditure on health to real GDP) is the main contributor to real GDP per capita rise followed by education human capital (proxied by secondary school enrolment). Such findings are consistent with the endogenous growth theories which argue that an improvement in human capital (skilled and healthy workers) improves productivity. In the short run, the coefficient of error correction term is -0.7366 suggesting about 73.66 percent annual adjustment towards long run equilibrium. This is another proof for the existence of a stable long run relationship among the variables. The estimated coefficients of the short-run model indicate that education is the main contributor to real GDP per capita change followed by gross capital formation (one period lagged value) and government expenditure (one period lagged value). But, unlike its long run significant impact, health has no significant short run impact on the economy. Even its one period lag has a significant negative impact on the economy.
 The above results have an important policy implication. The findings of this paper imply that economic performance can be improved significantly when the ratio of public expenditure on health services to GDP increases and when secondary school enrolment improves. Such improvements have a large impact on human productivity which leads to improved national output per capita. Hence policy makers and / or the government should strive to create institutional capacity that increase school enrolment and improved basic health service by strengthening the infrastructure of educational and health institutions that produce quality manpower. In addition to its effort, the government should continue its leadership role in creating enabling environment that encourage better investment in human capital (education and health) by the private sector.

CRITICAL PERIODS DURING CHILDHOOD AND ADOLESCENCE

We identify the ages that constitute sensitive (or critical) periods in children's development towards their adult health status, skills, and human capital. For this, we use data on families migrating into Sweden from countries that are poorer, with less healthy conditions. Late-life health is proxied by adult height and other adult outcomes. The relation between siblings' ages at migration and their adult outcomes allows us to estimate the causal effect of conditions at specific childhood ages. We effectively exploit that, for siblings, the migration occurs simultaneously in calendar time but at different developmental stages (ages). We find evidence that the period just before the puberty growth spurt constitutes a critical period for adult height and we find related critical periods for adult cognition, mental health, and education.

Health Capital and Human Capital as Explanations for Health-Related Wage Disparities

We use a dynamic modeling strategy to evaluate two potential avenues through which health differences generate a wage gap: directly through reductions in health capital and indirectly through employment transitions that reduce human capital (specifically, occupation and employer tenure). Our results suggest that male workers with a moderate disability are 23 percent more likely to change occupations or employers than nondisabled men. Compared to those who do not make a transition, workers with a moderate disability who change occupations and employers experience an immediate $0.30 decline in hourly wages on top of a $0.57 decline associated with the disability onset.

Age differences in mammography screening reconsidered: life course trajectories in 13 European countries.

Breast cancer is the most common cause of cancer mortality among European women. To reduce mortality risk, early detection through mammography screening is recommended from the age of 50 years onwards. Although timely initiation is crucial for cancer prognosis, the temporal dimension has largely been ignored in research. In cross-sectional research designs, it is not clear whether reported age differences reflect 'true' age effects and/or presumed period effects resulting from evolving knowledge and screening programmes. We use longitudinal data from the survey of Health, Ageing and Retirement (SHARELIFE, 2008), which enables to cast light on age differences by providing retrospective information on the age at which women commenced regular mammography screening. Moreover, the cross-national dimension of the SHARE permits framing the results within the context of nationally implemented screening programmes. By means of the Kaplan-Meier procedure, we examine age trajectories for five 10-year birth cohorts in 13 European countries (n = 13 324). Birth cohorts show very similar age trajectories for each country. Along with the observation that large country differences and country-specific deviations coincide with screening programme characteristics, this suggests strong period effects related to implemented national screening programmes. Age differences in mammography screening generally reflect the period effects of national screening policies. This leaves little room for economic theories about human health capital that leave out the institutional context of preventive health care provision.

A critique of the perceived solid conceptual foundations of ISEW & GPI — Irving Fisher's cognisance of human-health capital in ‘net psychic income’

This paper puts forward a political economy critique of the perceived solid conceptual foundations of Sustainable Well-Being Indicators (SWBIs) such as ISEW and GPI. A particular version of ‘entropic net psychic income’ has been implanted as the main conceptual basis for these aggregated measures of sustainable economic welfare. However, a well-known limitation of SWBIs is that they do not prudently factor-in measures of investment and depreciation of ‘human-health capital’—yet this is a critical aspect of sustainable well-being. It is argued that under Fisher's psychic income framework, the heart of the indicator is a theory that specifies accounting for some sort of change in the human psyche, i.e. the stock (or fund) of human-health capital. Advocates of SWBIs cannot adequately account for the degree of human health or knowledge, because this is not their reference point—‘personal consumption expenditures’ is their reference point. Political economy seeks to avoid abstracting from the whole reality, recognising that endogenous processes of human-health capital formation are overdetermined. This paper thus argues that there is a significant conceptual shortcoming in ISEW and GPI, which, if left unattended will undermine the measure of theoretical legitimacy and empirical efficacy.

The failure of the ISEW and GPI to fully account for changes in human-health capital — A methodological shortcoming not a theoretical weakness

Andrew Brennan (Ecological Economics, 2013--this issue) has argued that the Index of Sustainable Economic Welfare (ISEW) and Genuine Progress Indicator (GPI) are theoretically flawed because, as indicators designed to capture the net psychic income generated by economic activity, they fail to incorporate net changes in human-health capital. To a lesser extent, Brennan is also critical of the fact that the ISEW and GPI are unable to reflect both economic welfare and sustainability. Whilst I'm happy to concede that the two indicators fail to fully account for changes in human-health capital, it is my contention that this failure represents, at most, a methodological shortcoming. It does not amount to a theoretical weakness. Despite Brennan's best efforts, the ISEW and GPI remain soundly based on Irving Fisher's distinction between income and capital. Indeed, Brennan's suggested modifications to the ISEW and GPI do nothing but conflate income and capital, which, if taken on board, would lead to misleading indicators of total economic welfare. As for not reflecting both economic welfare and sustainability, I have long argued that the ISEW and GPI merely reflect the former and need to be supplemented by biophysical indicators to determine whether the economic welfare being enjoyed by a nation is sustainable. The fact that the ISEW and GPI only reflect economic welfare is not a weakness, since no indicator can or should attempt to reflect both conditions. The use of strong sustainability approaches to calculate the environment costs incorporated in the ISEW and GPI is not an exercise designed to measure sustainability. It is an exercise in good economic accounting.

Health Effects of Socioeconomic Status: Methods and Findings

Abstract: We present a framework for analysing causal effects of socioeconomic status on health human capital. We analyse the role played by instrumental variables in the identification of causal effects. We show, by empirical examples that, the types of data available in many African countries can be used to estimate causal effects of socioeconomic status on health.

War and Stature: Growing Up during the Nigerian Civil War

The Nigerian civil war of 1967-70 was precipitated by secession of the Igbo-dominated south-eastern region to create the state of Biafra. It was the first civil war in Africa, the predecessor of many. We investigate the legacies of this war four decades later. Using variation across ethnicity and cohort, we identify significant long-run impacts on human health capital. Individuals exposed to the war at all ages between birth and adolescence exhibit reduced adult stature and these impacts are largest in adolescence. Adult stature is portentous of reduced life expectancy and lower earnings.

Health Human Capital and Economic Development

Lifespan has doubled in the world in the last 200 years. In the last 50 years, this advance in health, measured by expectation of life at birth, has been shared more equally among people than the increase in income. The record of this concurrent increase in lifespan and income per capita suggests it may be important to understand how these events are interrelated. The connections between health and development are controversial, in part because the evidence on this topic comes from different scientific disciplines, answering different questions, relying on different types of data and using different analytical methods. However, hypotheses are emerging that merit much more study in Africa and elsewhere, to guide the allocation of resources for health, which will entail refinement of conceptual frameworks to isolate causal relationships through more rigorous empirical testing, and collection of new data for more decisive tests. Two types of relationships are distinguished: first, the linkages between conditions under which people live and their expected lifespan and health status, which characterise the technology of ‘health production functions’; second, the relationship between an individual's stock of health and her or his economic productivity, well-being and duration of life, which characterise ‘returns to health human capital’. In the last 50 years, the lifespan at birth of the relatively rich and poor converged, at least until the 1990s. There are indications that this was achieved mainly by improvements in nutrition and control of infectious diseases concentrated in childhood that were relatively cheap to disseminate. To control mortality and reduce disability among adults confronting degenerative chronic diseases has proved more costly, and the relatively poor may thus not benefit as much as the rich from the dissemination of these newer medical technologies unless subsidised. However, the prior reduction in childhood illnesses may itself contribute to improved adult health outcomes later in the life cycle. Birth cohorts which have experienced diminished infections and inflammatory illnesses in utero and early childhood and received better early nutrition may also increase their potential economic productivity as adults, as well as live longer lives free of disability.

Endemic Diseases and Development: Introduction and Overview

Evidence abounds to support the view that while health, measured by life expectancy, had improved, and converged in the world, the income or economic prosperity did not. Recent literature tried to show that poor health and endemic diseases in Africa may constitute a barrier to growth. However, the connections between health and economic development are controversial. The papers presented in this volume deal with this issue and discuss the different channels by which diseases affect the economy and how adequate policy may improve health. The first paper by T. Paul Schultz on health human capital and economic development analyses the interrelations between health and economic development raising the difficulty of estimating those connections due to some methodological constraints. He also shows the importance of distinguishing between the technology of ‘health production functions’ and the relationship between an individual's stock of health and her or his economic productivity, duration of life and returns to health human capital. He underlines that in low-income countries and specifically in Africa, improvements in nutrition and control of endemic diseases concentrated in childhood were relatively cheap and have contributed to a convergence of lifespan. And the prior reduction in childhood illnesses may itself contribute to improved adult health outcomes later in the life, such as to increase their potential economic productivity as adults. The second paper by D. Weil on endemic diseases and African economic growth argues about the need for investing more in health in Africa, as the actual income gain from better health and endemic disease elimination is large. Considering that the burden of diseases is not only a public health matter but also an economic matter, the author focuses on the effect of diseases on economic growth. He shows that its effects act through numerous channels at different time horizons. A simulation model that may describe these channels at the aggregate level is then discussed. The third paper by M. Audibert on endemic diseases and agricultural productivity confirms, like Schultz and Weil did, that connections between health, measured here by endemic diseases, and economic prosperity, are controversial. She shows that the magnitude of the economic effect of diseases depends on the disease itself, the worker productivity and the existence or not of coping mechanisms. She also examines the reverse causation of the association by wondering whether intensive agriculture may be a risk factor for health.Finally the last paper by M. Mackintosh and P. Mujinja on markets and policy challenges in access to essential medicines for endemic disease questions the reliance on the efficient market mechanism. While international policy framework for promoting essential medicines lacks coherence, authors, studying the medicines market in Tanzania, provide evidence that competent government and non-profit providers could improve the behaviour of the commercial providers for a rational use of essential medicines.

Poverty, Access to Health Care Services and Human Capital Development in Nigeria

The paper is aimed at examining the poverty profile of Nigeria and its consequences on access to health care services and human capital development in the country. It is a startling paradox that about two – thirdsof Nigerians are poor despite living in a country with vast potential wealth. Apart from looking at the theoretical milieu, the paper also examined the nature and dimensions of poverty in Nigeria. The paper which employed secondary methods of data collection revealed that the achievement of eventhe modest goal of stopping the traumatic march of poverty has so far eluded Nigeria. It further revealed that health is a major component of a nation’s socio-economic development because it is essential for a virile labour forcefor the creation and maintenance of its wealth. The paper however, recommended comprehensive health sector reform, aimed at strengtheningthe national health system and enhancing the delivery of effective and affordable health services.

Health trends in Sub-Saharan Africa: Conflicting evidence from infant mortality rates and adult heights

We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1961. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital.

Adolescent Early Death Perception: Links to Behavioral and Life Outcomes in Young Adulthood

Introduction The purpose of this study was to examine the relationship between changes in adolescent perception of risk for early death over time and behavioral and life outcomes in young adulthood. Methods This is a secondary data analysis of 7202 respondents participating in waves 1 (1995), 2 (1996), and 3 (2001-2002) of the in-home interviews from the National Longitudinal Study of Adolescent Health. Linear and logistic regression models were used to determine the predictive ability of adolescent early death perception at waves 1 and 2 on young adult outcomes of health risk, human capital, and prosocial development, and fitness at wave 3. Results Nearly one in four youth (23%) expressed perceived risk of premature death at some point in time; 6% of youth persisted in this outlook. Perceived risk of premature death during adolescence was linked to poor health and productivity on multiple levels in young adulthood. Discussion Adolescent perceived risk for premature death portends poor outcomes in young adulthood. Findings support incorporating screening questions on adolescents' mortality beliefs into psychosocial assessments and interviews.

Health Human Capital, Height and Wages in China

We estimate the returns to height using data from 12 Chinese cities. We present both ordinary least squares (OLS) and two-stage least squares (TSLS) estimates. In the latter height is instrumented using proxies for health human capital, accumulated in childhood and adolescence, which influence adult height. The TSLS estimates are much higher, reflecting the fact that the OLS estimates are determined by the random genetic factors influencing height, while the TSLS estimates also take into account returns from investment in health human capital during childhood and adolescence. These results imply considerable returns to investment in health human capital.

Brains versus Brawn: Labor Market Returns to Intellectual and Health Human Capital in a Poor Developing Country

Previous studies report that adult height has significant associations with wages even controlling for schooling. But schooling and height are imperfect measures of adult cognitive skills (“brains”) and strength (“brawn”); further they are not exogenous. Analysis of rich Guatemalan longitudinal data over 35 years finds that proximate determinants - adult reading comprehension skills and fat-free body mass - have significantly positive associations with wages, but only brains, and not brawn, is significant when both human capital measures are treated as endogenous. Even in a poor developing economy in which strength plausibly has rewards, labor market returns are increased by brains, not brawn.

Population and Health Policies

The program evaluation literature for population and health policies is in flux, with many disciplines documenting biological and behavioral linkages from fetal development to late life mortality, chronic disease, and disability, though their implications for policy remain uncertain. Both macro and micro economics seek to understand and incorporate connections between economic development and the demographic transition. The focus here is on research methods, findings, and questions that economists can clarify regarding the causal relationships between economic development, health outcomes, and reproductive behavior, which operate in many directions, posing problems for identifying causal pathways. The connection between conditions under which people live and their expected lifespan and health status refers to 'health production functions.' The relationships between an individual’s stock of health and productivity, well being, and duration of life encompasses the 'returns to health human capital.' The control of reproduction improves directly the well being of women, and the economic opportunities of her offspring. The choice of population policies may be country specific and conditional on institutional setting, even though many advances in biomedical and public health knowledge, including modern methods of birth control, are now widely available. Evaluation of a policy intervention in terms of cost-effectiveness is typically more than a question of technological efficiency, but also the motivation for adoption, and the behavioral responsiveness to the intervention of individuals, families, networks, and communities. Well-specified research strategies are required to address (1) the economic production of health capacities from conception to old age, (2) the wage returns to increasing health status attributable to policy interventions, (3) the conditions affecting fertility, family time allocation, and human capital investments, and (4) the consequences for women and their families of policies which change the timing as well as number of births.

Effect of Health Human Capital Expenditure on Economic Growth in India: A State Level Study

Effect of Health Human Capital Expenditure on Economic Growth in India: A State Level Study

Extent and determinants of cost of road traffic injuries in an Indian city

Studies aimed at estimating losses that are incurred as a result of road traffic injuries (RTIs), especially at the family level, are very limited. To ascertain the direct and productivity costs of road traffic injuries and their determinants. This study was a cross-sectional survey of all the road traffic crashes recorded by traffic police during 2004 in Chandigarh, a modern planned city of north India. All road traffic crashes recorded by the traffic police during the year 1st January to 31st December 2004 were included in the study. The houses of all the victims were visited. The direct costs included the immediate medical costs (i.e., emergency and hospital care, follow-up care, medicines and appliances, doctor bills, etc.), and nonmedical costs (transportation, property damage cost, etc.). Work productivity and activity questionnaire (WPAI-SHP), the health and labor questionnaire (HLQ) and Human Capital Method were used for estimating the productivity costs. Percentage, mean, standard deviation of the outcome parameters were calculated. Of the 121 crash victims listed, 95 agreed to participate in the study. The net direct costs incurred were Rs. 8,55,644 ($19,991). The vehicle repair costs constituted more than half of such cost. Surgery, which was conducted in 28 cases, constituted 14.5% of the direct costs. The total productivity cost incurred was Rs. 8,06,24,530 ($1,883,750). Costs incurred due to premature mortality constituted over 99% of these productivity losses suffered by society. Lost wages due to the crash constituted less than 1% [Rs. 1,40,230 ($3276)] of the total productivity loss. Road traffic injuries are a significant financial drag on the society. The productivity costs far outweigh the direct costs. Premature mortality, vehicle damage and medical costs constituted the major share of the cost of RTIs.